Thursday, 16 October 2014

The Complications Of Medical Billing Are Made Easier By The System Of Cpt Codes

By Patty Goff


Medical billing can be a complicated endeavor. There are a high number of illnesses, surgeries and much information to remember. The person who functions in this medical position will use the Current Procedural Terminology or cpt codes, on a regular basis.

Experts sitting on a panel, the CPT editorial panel, oversee the administration of the coding. Of experts exists called the CPT Editorial Panel. They work under the auspices and direction of the AMA. There is a copyright owned and protected by that august organization.

The coding system was devised to facilitate clarity in the communications sent from one medical expert to another department. There are separate ones to identify surgical procedures, diagnostic services and general medical procedures.

The ICD-10 coding system is used to specify what a patient is being treated for. The three types of CPT codes are used to differentiate among all the procedures, care services and surgeries. There are three separate categories, each having separate sections to cover various similar services. Some examples place in Category I are outpatient, Nursing Home and Home Health Care Nursing.

There are specific ones for the administration of anesthesia. Each code refers to a body part or type of procedure. For example, upper or lower abdomen, radiological procedures and neck are each assigned their own code.

Each surgery has a separate number to identify it. For example, surgery to the reproductive system, repairing a deviated septum and a cochlear implant would each be assigned a number. This makes a bill easier for the patient and insurance carrier to understand.

Radiology includes diagnostic ultrasound, radiation oncology and mammography. The mammogram is most often a routine check for breast cancer. It is administered by a nurse and read by a physician.

Another category is pathology and laboratory. Drug testing, a simple urinalysis and various testing of the blood fall under this category. Transfusions are included. The postmortems, also known as autopsies, are classified here.

Routine vaccinations, administration of immunizations and kidney dialysis treatments fall under the numbers for medicine category. When someone has severe kidney disease, the dialysis keeps that person alive until a replacement kidney is matched to their blood type. A kidney transplant will relieve them of the need for dialysis.

Specialists also fall under the class of those used for medicine. Some specialties include otorhinolaryngology, psychiatry and cardiology. The cardiologist is known as the heart doctor and the otorhinolaryngologist is, in laymans terms, an ear, nose and throat doctor.

Under category II the codes include a letter of the alphabet as the fifth character in the code. For example, you will find four digits and then an alphabetical character. The eleven category II codes include physical examination, diagnostic screening processes or the results and patient history.

Psychotherapy and other counseling services are in Category III. It does not include psychiatric counseling. Some of the numbers are retired when experts feel they are no longer needed. They are evaluated on a yearly basis.

It is true that CPT is a copyright protected registered trademark belonging to the American Medical Association. However, its use is not limited to that organization. It is used by other health care organizations. Some examples are the Centers for Medicare and Medicaid, and the Federal Register. Each pays a licensing fee to entitle them to utilize the code.




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