Chapter 2 Flashcards
Evaluation and Management (E/M) Anesthesiology Surgery Radiology Pathology and Laboratory Medicine
CPT Category I—Major Sections
Physician visit codes Consultation codes Emergency department services Critical care Nursing facility care
Evaluation and Management
Anatomic format
Selection based on surgical procedure performed
Include general, regional, supplementation of local anesthesia
Includes preop and postop visits, monitoring, administration of fluids and/or blood
Some insurance carriers use time for reimbursement
Anesthesiology
Largest section and most difficult
Note section divided into: Section (Surgery) Subsection/category (Urinary system) Subcategory (Kidney) Heading (Incision) Procedure codes (50010)
Surgery
Four subsections: Diagnostic radiology Diagnostic ultrasound Radiation oncology Nuclear medicine
Most hospitals maintain these codes in computerized file (chargemaster)
Radiology
Most hospitals maintain codes in an electronic file (chargemaster)
Physicians maintain list of common procedures performed (superbill or computer file)
Pathology and Laboratory
Specialized section
Types of codes: Psychiatric services Physical therapy Ophthalmological services Cardiac catheterization
Medicine
Performance measurements
For data collection
End with letter F
Use is optional
Example:
4008F Beta-blocker therapy prescribed or currently being taken
Category II Codes
Emerging technology Alphanumeric codes ending in T Used for data collection Temporary Updates available on the AMA website Payment depends on the payer
Example:
0085T Breath test for heart transplant rejection
Category III Codes
Allows the coder to assign a code to a procedure not listed in CPT
Assigned as a last resort
Payers want documentation (operative report)
Note: The Alphabetic Index lists all unlisted procedures.
Example: 45999 Unlisted procedure, rectum
Unlisted Procedure
What Appendix is the list of modifiers?
Appendix A
What Appendix is the Summary of additions, deletions, and revisions?
Appendix B
First step for locating a code (after familiar with procedure) Alphabetic list Main terms in bold print Subterms indented Never code directly from the index
Index
When coding with CPT you must always reference the ____?
They are guidelines for the use of CPT codes
Notes
When you have several codes to chose from you must _______.
Look at each code in the tabular part
