Optional CPT codes the track performance measures to improve patient’s health.
Category II codes
Temporary codes for emerging technology, services, and procedures. May become another code set if used widely in the future.
Category III codes
Five digit procedure codes found in the main body of CPT. Each code has a descriptor.
Category I codes
What does CPT stand for?
Current procedural terminology he
How is the CPT organized?
The CPT contains the main text which is six sections of category I codes: -Evaluation and management -Anesthesia -Surgery -Radiology -Pathology and laboratory -Medicine •Category II and Category III codes have 14 appendixes and an index
What are usage notes at the beginnings of CPT sections?
Section guidelines
What is a service not listed in CPT?
Unlisted procedure
What is a note explaining the reasons for a new, variable, or unlisted procedure or service?
Special report
When does the CPT use a semicolon and indentions?
- When some quotes and descriptors are followed by indented see or use entries in parentheses
- Descriptors often contain clarifying examples in parentheses, sometimes with abbreviations e.g.
What are the symbols used in CPT and what do they stand for? (6)
- A bullet indicates a new procedure code
- A triangle indicates the codes descriptor has changed
- facing triangles enclose new or revised text other than the codes descriptor
- A bullet in a circle next to a code means conscious sedation is a part of the procedure the surgeon performs
- A lightning bolt is used for codes for vaccines that are pending FDA approval
- A number sign (#) indicates a resequenced code
CPT procedure codes reassigned to another sequence.
Resequenced
What is the CPT modifier?
A two digit-number that may be attached to most five-digit procedure codes. Modifiers communicate special circumstances involved with procedures.
What are the two parts of a procedure?
- Technical component (TC)- reflects the technicians work and the equipment and supplies used
- Professional component (PC)- represents a physician’s skill, time, and expertise used
What are the six general steps for selecting correct CPT procedure codes?
- Review complete medical documentation
- Abstract the medical procedures from the visit documentation
- Identify the main term for each procedure
- Locate the main terms in the CPT index
- Verify the code in the CPT main text 6. Determine the need for modifiers
Codes that’s cover physician services performed to determine the optimal course for patient care.
E/M codes
A factor documented for various levels of evaluation and management services.
Key component
What are the key components for selecting E/M codes? (3)
- The extent of the history documented
- The extent of the examination documented
- The complexity of the medical decision-making
What is a service in which a physician advises a requesting physician about a patient’s condition and care?
Consultation
What is a patient who receives health care in a hospital setting without admission?
Outpatient
What are the two types of modifiers used with anesthesia codes?
- Modifier that describes patient’s health status
2. Standard modifiers
What is the code used with procedure codes to indicate a patient’s health status?
Physical status modifier
What are the modifiers that describe a patient’s physical status?
P1: normal, healthy patient
P2: patient with mild systemic disease
P3: patient with severe systemic disease
P4: patient with severe systemic disease that is a constant threat to life
P5: moribund patient who is not expected to survive without the operation
P6: declared brain-dead patient whose organs are being removed for donation purposes
What is the largest procedure code section?
The surgery section
What is a combination of services included in the single procedure code?
Surgical package (or global surgery rule)
