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Cpt Codes Exist To Facilitate Medical Billing

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By Patty Goff


Medical billing is a complicated position that requires training. There are a myriad of procedures, medications and illnesses with difficult to spell names. A coder must know the Current Procedural Terminology, known as the cpt codes to function in that position.

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.

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.

There are three types of CPT code, which differentiates between procedures. These are Category I, Category II and Category III. Some examples of the first category are outpatient care, Home health care and in-patient care in a retirement home.

They become very specific. One is used for any administration of anesthesia. A separate set of numbers is used to refer to each body part that is operated on. Examples include head, back, extremities, which have separate numbers.

The individual code numbers for surgical procedures include integumentary system, reproductive system and auditory system. The now successful cochlear implant surgery would be classified under auditory system. As you can see, this makes billing run smoothly.

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.

The ones for the category named medicine include routine vaccinations, administering those immunizations and treatments for kidney disease, which are transfusions to clean the blood. It is dialysis that maintains the patients life while they wait for a kidney transplant. After that, if successful, they will no longer require dialysis treatments.

This same classifications for medicine include psychiatry, special otorhinolaryngologic services and noninvasive vascular diagnostic studies. The otorhinolaryngologic specialist is also known as an ear, nose and throat man or woman.

Numbers in Category II have four numbers followed by an alphabetical letter to identify them. This classification contains eleven codes. Included are routine physical exams, diagnostic screenings and taking the patients medical history.

Under Category III you will find the ones for psychotherapy and other counseling services. From time to time codes are retired. This year will not see a change in the psychological testing code. Each year they are re-evaluated.

The American Medical Association owns the registered trademark and the copyright belongs to them. They license it out to other medical organizations for their use. The Centers for Medicare and Medicaid, and the Federal Register make use of these codes to make their billing work function smoothly.




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