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

By Patty Goff


There are so many complicated procedures in the medical field that it makes billing difficult. All the illnesses, procedures and medicines have complicated names. The individual who is qualified to work as a coder will have to be familiar with the Current Procedural Terminology or cpt codes to perform those duties.

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.

This code was created to make clear what was administered to each patient in the communications transmitted from one medical department to another. Separate ones identify diagnoses, surgeries and all other medical processes.

ICD-10 coding identifies the illness or condition a patient is suffering from. Three types of CPT code exist, identified as Category I, Category II and Category III. In Category I you will find six sections. Some examples of Category I are Office or outpatient, Critical care and Home health care services.

They become very specific. One is used for any administration of anesthesia. A separate set of numbers is used to refer to each body part that is operated on. Examples include head, back, extremities, which have separate numbers.

Each surgery has a separate number to identify it. For example, surgery to the reproductive system, repairing a deviated septum and a cochlear implant would each be assigned a number. This makes a bill easier for the patient and insurance carrier to understand.

Codes for radiological procedures include radiation oncology, mammography and all diagnostic ultrasound procedures. This includes those used to examine the baby when a woman is pregnant. Sometimes the sex of the baby can be identified in this procedure.

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.

The ones for the category named medicine include routine vaccinations, administering those immunizations and treatments for kidney disease, which are transfusions to clean the blood. It is dialysis that maintains the patients life while they wait for a kidney transplant. After that, if successful, they will no longer require dialysis treatments.

This same classifications for medicine include psychiatry, special otorhinolaryngologic services and noninvasive vascular diagnostic studies. The otorhinolaryngologic specialist is also known as an ear, nose and throat man or woman.

They include a letter of the alphabet to indicate they belong in Category II. There will be four numbers and then a letter of the alphabet. There are eleven Category II codes that include diagnostic screenings, taking a patient history and physical examination.

Psychotherapy and other counseling services are in Category III. It does not include psychiatric counseling. Some of the numbers are retired when experts feel they are no longer needed. They are evaluated on a yearly basis.

The American Medical Association owns the registered trademark and the copyright belongs to them. They license it out to other medical organizations for their use. The Centers for Medicare and Medicaid, and the Federal Register make use of these codes to make their billing work function smoothly.




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