Wednesday, October 15, 2014

The Complications Of Medical Billing Are Made Easier By The System Of Cpt Codes

By Patty Goff


Medical billing can be a complicated endeavor. There are a high number of illnesses, surgeries and much information to remember. The person who functions in this medical position will use the Current Procedural Terminology or cpt codes, on a regular basis.

Experts sitting on a panel, the CPT editorial panel, oversee the administration of the coding. Of experts exists called the CPT Editorial Panel. They work under the auspices and direction of the AMA. There is a copyright owned and protected by that august organization.

The code facilitates clarity in communication from one medical department to another. It covers descriptions of diagnostic, surgical and medical care for coders. It identifies what service a patient is being billed for.

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.

There are specific ones for the administration of anesthesia. Each code refers to a body part or type of procedure. For example, upper or lower abdomen, radiological procedures and neck are each assigned their own code.

Individual numbers assigned to surgical services may include pelvic, reproductive system and auditory system. To make the billing very specific, a cochlear implant surgery is classified under auditory system. Billing is rendered less complicated when used in the bills sent out to the patient.

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.

Under those identifying Medicine you will find vaccines, any immunization administration and kidney dialysis. The individual with advanced kidney disease will have to undergo dialysis on a regular basis to remain alive. Many of these patients are waiting for a kidney transplant.

Treatments by medical specialists come under the class of those indicating medicine. The specialists can be board-certified in psychiatry, cardiology or otorhinolaryngology. The psychiatrist treats the mind, the cardiologist the heart and the otorhinolaryngologist, the ears, nose and throat.

Under category II the codes include a letter of the alphabet as the fifth character in the code. For example, you will find four digits and then an alphabetical character. The eleven category II codes include physical examination, diagnostic screening processes or the results and patient 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.

It is true that CPT is a copyright protected registered trademark belonging to the American Medical Association. However, its use is not limited to that organization. It is used by other health care organizations. Some examples are the Centers for Medicare and Medicaid, and the Federal Register. Each pays a licensing fee to entitle them to utilize the code.




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