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Cpt Codes Exist To Facilitate Medical Billing

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.

There is a panel of experts who oversee maintenance of the medical code under the direction of the American Medical Association. It is called the CPT Editorial Panel. It is copyright protected by the AMA.

This code was created to make clear what was administered to each patient in the communications transmitted from one medical department to another. Separate ones identify diagnoses, surgeries and all other medical processes.

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.

They are item specific. One category applies to the administration of anesthesia. Each body part that is being operated on uses a separate code. Some examples include the extremities, the head and the eyes.

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.

There are those for radiology, which include treatments of radiation oncology, mammograms and ultrasound tests. Pregnant women can be reassured that the baby is healthy. It is often possible to identify if the baby is a boy or girl.

Pathology and laboratory are another category. Included are drug tests, evocative suppression testing and the simple urinalysis administered as part of any routine exam in the physicians office. Complicated testing includes hematology and coagulation, transfusion medicine and the postmortem anatomic pathology.

Under those identifying Medicine you will find vaccines, any immunization administration and kidney dialysis. The individual with advanced kidney disease will have to undergo dialysis on a regular basis to remain alive. Many of these patients are waiting for a kidney transplant.

Treatments by medical specialists come under the class of those indicating medicine. The specialists can be board-certified in psychiatry, cardiology or otorhinolaryngology. The psychiatrist treats the mind, the cardiologist the heart and the otorhinolaryngologist, the ears, nose and throat.

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.

Although the AMA is the owner of both the registered trademark and the copyrights to the CPT code, they share it with other medical facilities. Some are The Federal Register and the organization that bills for Medicare and Medicaid. Each is required to pay for a license that entitles them to use it. It makes their billing systems run smoothly.




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