6 Questions
What does CPT stand for?
Current Procedural Terminology
Which category of CPT codes is used for emerging technology and new procedures?
Category III
What is the purpose of modifier 25?
Used to indicate a separate E/M service on the same day as a procedure
What is the purpose of the first digit in a CPT code?
Indicates the category of the code
Which of the following is a category of CPT codes?
Medicine
What is one of the importance of CPT codes?
To facilitate communication between healthcare providers and payers
Study Notes
What are CPT codes?
- CPT stands for Current Procedural Terminology
- Developed and maintained by the American Medical Association (AMA)
- Used to report medical, surgical, and diagnostic procedures and services
Types of CPT codes:
- Category I: Codes for routine medical and surgical procedures
- Category II: Codes for performance measurement and claims-based reporting
- Category III: Codes for emerging technology and new procedures
Structure of CPT codes:
- 5-digit code (e.g., 99213)
- First digit: Category (1, 2, or 3)
- Remaining digits: Specific procedure or service
CPT code categories:
- Evaluation and Management (E/M): Codes for office visits, hospital visits, and consultations
- Anesthesia: Codes for anesthesia services
- Surgery: Codes for surgical procedures
- Radiology: Codes for radiology services
- Pathology and Laboratory: Codes for laboratory tests and pathology services
- Medicine: Codes for medical procedures and services
CPT code modifiers:
- Modifier 25: Used to indicate a separate E/M service on the same day as a procedure
- Modifier 59: Used to indicate a distinct procedural service
- Modifier 76: Used to indicate a repeat procedure or service
Importance of CPT codes:
- Used for billing and insurance reimbursement
- Standardize medical procedures and services
- Facilitate communication between healthcare providers and payers
- Support quality improvement and research initiatives
What are CPT codes?
- CPT stands for Current Procedural Terminology, developed and maintained by the American Medical Association (AMA)
- Used to report medical, surgical, and diagnostic procedures and services
CPT Code Categories
- Category I: Codes for routine medical and surgical procedures
- Category II: Codes for performance measurement and claims-based reporting
- Category III: Codes for emerging technology and new procedures
Structure of CPT codes
- 5-digit code (e.g., 99213)
- First digit: Category (1, 2, or 3)
- Remaining digits: Specific procedure or service
CPT Code Categories and Subcategories
- Evaluation and Management (E/M): Codes for office visits, hospital visits, and consultations
- Anesthesia: Codes for anesthesia services
- Surgery: Codes for surgical procedures
- Radiology: Codes for radiology services
- Pathology and Laboratory: Codes for laboratory tests and pathology services
- Medicine: Codes for medical procedures and services
CPT Code Modifiers
- Modifier 25: Separate E/M service on the same day as a procedure
- Modifier 59: Distinct procedural service
- Modifier 76: Repeat procedure or service
Importance of CPT codes
- Used for billing and insurance reimbursement
- Standardize medical procedures and services
- Facilitate communication between healthcare providers and payers
- Support quality improvement and research initiatives
Learn about the basics of CPT codes, including their types and structure, in the context of medical billing and healthcare services. CPT codes are used to report medical procedures and services.
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