1. Chapter 6
CPT Codes

2. CPT Codes What are they used for? What are they? Who uses them?
5 digit numbers
What are they used for?
to replace service descriptions
Who uses them?
Anyone billing for service will use a procedure code. Could be CPT, HCPCS, or other service codes. Outpatient services provided by a doctor use CPT codes.

3. CPT Book Updated every year in October
updates could include new technology or new way of performing a procedure
Examples: 2013 new codes
24370 Revision of total elbow arthroplasty, including allograft when performed, humeral or ulnar component
24371 Revision of total elbow arthroplasty, including allograft when performed, humeral and ulnar component

4. CPT Nomenclature Symbols Revised code =  New Code = 
New or revised text = 
Add-on code =  is an add on code, it can only be used with 32505

5. Guidelines
Just like ICD-9, read guidelines for each chapter to get instruction for coding that chapter’s codes
Surgery Guideline:
Surgical destruction is a part of a surgical procedure and different methods of destruction are not ordinarily listed separately unless the technique substantially alters the standard management of a problem or condition. Exceptions under special circumstances are provided for by separate code numbers.

6. Modifiers
Two-digit numbers added to a CPT code to modify the code description
Examples:
-25 significant, separate E/M performed on same day
-50 bilateral procedure
-62 two surgeons
-LT and –RT left and right side (HCPCS modifiers)

7. Factors for E/M
Place of Service (hospital, nursing facility, critical care, office, ER)
Type of Service (consultation, office visit, newborn care, preventive medicine)
Patient Status (new/established patient, inpatient/outpatient, referral)

8. Levels of Service
Look at E/M codes for Office or Other Outpatient Services
Patient Status
Chief Complaint, history of present illness (PI); review of systems (ROS); past, family, and social history (PFSH)
Level of Service (key components)
Problem focused, expanded problem focused, detailed, comprehensive

9. Assigning CPT Codes Identify main term
Probably a verb indicating what service was performed
Discection
Repair
Anesthesia (administration)
graft

10. Assigning CPT Codes Look up main term in Alphabetic Index
If the word you identify is not directing you to the code you need, think of another way to say what was done
Example: Dead tissue around a burn is removed = debridement by body part

11. Assigning CPT Codes Verify the code suggested in the Alpha index
Pay attention to indents and ;
Look at code or 21401

12. Global Charges Many surgical procedures include Preop Intra op Post op
Complications to that surgery
supplies

13. Anesthesia and Radiology
There may be two service codes
One code for administering the anesthesia or taking the x-ray
Different code for the surgery or for reading the x-ray

14. Practice
What would be the code used to report the administration of anesthesia for a procedure on the esophagus?
Main term?
Anesthesia, esophagus
00500

15. Anesthesia, Achilles tendon repair
Practice
What would be the code used to report the administration of anesthesia for repair of a ruptured Achilles tendon?
Main term?
Anesthesia, Achilles tendon repair
01472