1. Procedural Coding: Introduction to CPT Chapter 5 Lecture 1

2. Learning Outcomes When you finish this chapter, you will be able to:
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When you finish this chapter, you will be able to:
5.1 Discuss the purpose of the CPT code set.
5.2 Describe the organization of the index, the main text, and the appendixes in CPT.
5.3 Summarize the format and seven of the symbols that are used in CPT.
5.4 Describe the purpose and correct use of CPT modifiers.
5.5 List the six general steps for selecting correct CPT procedure codes.
5.6 Explain how the key components are used as the basis for selection of CPT Evaluation and Management codes.

3. Learning Outcomes (Continued)
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When you finish this chapter, you will be able to:
5.7 Describe the purpose and the physical status modifiers used in the Anesthesia section of CPT Category I codes.
5.8 Recognize the concepts of the surgical package and of separate procedures in the Surgery section of CPT Category I codes.
5.9 State the purpose of the Radiology section of CPT Category I codes.
Describe the correct use of codes for laboratory panels in the Pathology and Laboratory section of CPT Category I codes.

4. Learning Outcomes (Continued)
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When you finish this chapter, you will be able to:
Explain why two codes from the Medicine section of CPT Category I codes are reported for immunizations.
Compare the purpose of Category II and Category III codes.

5. Key Terms add-on code ancillary services bundling Category I codes
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add-on code
ancillary services
bundling
Category I codes
Category II codes
Category III codes
conscious sedation
consultation
Current Procedural Terminology (CPT)
descriptor
E/M codes (evaluation and management codes)
fragmented billing
global period
global surgery rule
key component
modifier
outpatient
panel
physical status modifier
primary procedure

6. Key Terms (Continued) professional component (PC) resequenced
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professional component (PC)
resequenced
secondary procedure
section guidelines
separate procedure
special report
surgical package
technical component (TC)
unbundling
unlisted procedure

7. 5.1 Current Procedural Terminology, Fourth Edition (CPT)
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Procedure codes for physicians’ and other health care providers’ services are selected from the Current Procedural Terminology code set
Category I codes—five-digit procedure codes found in the main body of CPT
Each code has a descriptor—a brief explanation of the procedure
Category II codes—optional CPT codes that track performance measures
Category III codes—temporary codes for emerging technology, services, and procedures
Learning Outcome: 5.1 Discuss the purpose of the CPT code set.
Pages:
Look over the examples of Category I, II, and III codes on page 169.

8. 5.2 Organization
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CPT contains the main text, which has 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
Learning Outcome: 5.2 Describe the organization of the index, the main text, and the appendixes in CPT.
Pages:
Examine the definition, structure, and key guidelines for the six sections of Category I codes found in Table 5.1.

9. 5.2 Organization (Continued)
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Section guidelines—usage notes at the beginnings of CPT sections
Unlisted procedure—service not listed in CPT
Special report—note explaining the reasons for a new, variable, or unlisted procedure or service
Learning Outcome: 5.2 Describe the organization of the index, the main text, and the appendixes in CPT.
Pages:
Review an example of section guidelines.