Medical Coding and Billing - CPT Overview
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Questions and Answers

What does CPT stand for?

  • Common Procedural Terminology
  • Current Procedural Terminology (correct)
  • Current Procedure Task
  • Current Patient Terminology
  • What is the purpose of CPT coding?

    To provide a uniform language that describes surgical procedures and services.

    CPT codes are linked with ICD-9 codes.

    True

    Which of the following is NOT supported by CPT?

    <p>Personal Digital Assistant (PDA)</p> Signup and view all the answers

    What are the three categories of CPT codes?

    <p>Category 1, Category 2, Category 3</p> Signup and view all the answers

    What does Category 1 in CPT include?

    <p>Procedures and/or services identified by 5-digit codes.</p> Signup and view all the answers

    What does EDI stand for?

    <p>Electronic Data Interchange</p> Signup and view all the answers

    What is a special report in the context of CPT?

    <p>A document created when an unlisted procedure or service code is reported.</p> Signup and view all the answers

    What must accompany a claim for an unlisted procedure or service?

    <p>A narrative document.</p> Signup and view all the answers

    CPT modifiers are used to clarify services and __________ performed by providers.

    <p>procedures</p> Signup and view all the answers

    What three questions must be asked when coding surgeries correctly?

    <p>What body system was involved? What anatomic site was involved? What type of procedure was performed?</p> Signup and view all the answers

    Study Notes

    CPT Overview

    • CPT stands for Current Procedural Terminology and consists of codes for services and procedures required for insurance claims.
    • Provides a uniform language for describing surgical procedures and related services.
    • CPT codes are used for reporting services, linked with ICD-9 codes, and essential for justifying the need for medical procedures.

    Electronic Data Support

    • Supports Electronic Data Interchange (EDI) for streamlined claims processing.
    • Utilizes Computer-based Patient Records (CPR) for efficient patient information management.
    • Employs Electronic Media Claims (EMC) for the submission of claims electronically.

    CPT Categories

    • Category 1: Contains procedures/services with 5-digit codes for standard applications.
    • Category 2: Includes performance measurement tracking codes in alphanumeric format, with a letter in the last position (e.g., 4246C).
    • Category 3: Comprises temporary codes for emerging technologies used for data collection and reporting.

    CPT Structure

    • Organized into six sections:
      • Evaluation and Management (E/M)
      • Anesthesia
      • Surgery
      • Radiology
      • Pathology and Laboratory
      • Medicine

    Unlisted Procedures and Special Reports

    • Unlisted codes are assigned for procedures/services without specific CPT codes.
    • A special report is required when an unlisted code is used, detailing the service's nature and necessity.
    • A narrative document must accompany claims to describe the specifics of the service or procedure needed.

    Modifiers

    • CPT modifiers clarify specific services and procedures performed, providing additional details to the claims process.
    • A comprehensive list of CPT modifiers, along with descriptions, is found in the front cover of the CPT coding manual.

    Correct Surgery Coding

    • To code surgeries accurately, consider:
      • The body system involved.
      • The specific anatomic site affected.
      • The type of procedure performed.

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    Description

    This quiz focuses on the basics of CPT Coding, defining key terms and concepts essential for medical billing and coding. Learn about Current Procedural Terminology, its purpose, and its role in insurance claims. Test your knowledge with flashcards highlighting critical aspects of CPT.

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