PTP 2 Unit 2

Question 1

How are providers paid?

Answer 1

• Providers provide services
• Document the nesessary details for payment
• Assign codes to represent services rendered and other pertinent details
• Submit the claim
• Interpret payer’s response
• Prepare post-payment audit

Question 2

What is the Purpose of ICD-10 Codes?

Answer 2

• They are used to track health care statistics/disease burden, S/S, abnormal findings, social circumstances and external causes of injuries and/or disease, quality outcomes, mortality statistics and billing

ICD-10 was developed by WHO

Question 3

What is the Purpose of CPT Codes?

Who published and maintains CPT codes?

Answer 3

• CPT codes are used to describe tests, surgeries, evaluations and any other medical procedure performed by a healthcare provider on a patient
• CPT codes tell the insurance payer what procedure the heathcare provider would like to be reimbured for

American Medical Association (AMA)