CPT Codes CPT Coding Is a Fact Research Paper

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CPT Codes

CPT coding is a fact of life in the provision of healthcare today. CPT stands for Current Procedural Terminology, and is a system first developed by the AMA (American Medical Association) in 1966 "to convert widely accepted, uniform descriptions of medical, surgical and diagnostic services rendered by healthcare providers into five-numeric codes" (Medical Coding Experts, p. 1). CPT codes are necessary in order for accurate reimbursement to be obtained for services rendered and procedures performed. Inaccurate coding may result in a loss of reimbursement or, should extra codes be assigned and/or submitted, insurance fraud.

Category one CPT codes are the standard set of codes, and are divided into six sections. These sections are: evaluation and management; anesthesiology; surgery; radiology; pathology and laboratory; and medicine (Medical Coding Experts, p. 4). Each section has a discrete span of numbers that applies to the procedures classified under that section heading. They are as follows: evaluation and management, 99201-99499; anesthesiology, 00100-01999, 99100-99140; surgery, 11021-69990; radiology, 70010-79999; pathology and laboratory, 80048-89356; and medicine, 90281-99199, 99500-99602 (American Medical Association, p. 3).

One example of an evaluation and management code is 99253, which corresponds to a physical checkup, and requires the following characteristics: a detailed history; a detailed examination; and medical decision making of low complexity; another code from under this heading is 99213, which is also used to code for an annual exam, or physical.

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An example of an anesthesiology code is 00100, which reflects the use of anesthesia for procedures, including biopsy, on salivary glands. Another anesthesiology code is 01999, which is used to code for otherwise unlisted anesthesia procedures. An example of a surgical CPT code is 69990, used to code for microsurgical techniques requiring the use of an operating microscope; another surgical CPT code example is 33999, used for unlisted procedures related to cardiac surgery. One example of a CPT code under the radiology subject heading is 70010, used to code for myelography, posterior fossa, radiological supervision and interpretation. A second example is 72110, which is used for radiologic examination, spine, lumbosacral, complete with oblique views. 83912 is an example of a CPT code from the pathology and laboratory section; it corresponds to a genetic exam, whereas CPT code 85576 is used for a platelet aggregation. One example of a CPT code under the medicine section is 90658, which corresponds to a flu shot. Another….....

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