Questions and Answers
What does CPT stand for?
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?
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What are the three categories of CPT codes?
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What does Category 1 in CPT include?
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What does EDI stand for?
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What is a special report in the context of CPT?
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What must accompany a claim for an unlisted procedure or service?
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CPT modifiers are used to clarify services and __________ performed by providers.
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What three questions must be asked when coding surgeries correctly?
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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.
