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CPT 101: How-to Coding for Everyone · 2018. 12. 15. · CPT Coding for Non-Coders 2 CPT What is...
Transcript of CPT 101: How-to Coding for Everyone · 2018. 12. 15. · CPT Coding for Non-Coders 2 CPT What is...
Training Session Handouts
CPT 101: How-to Coding for
Everyone
Master Core CPT Rules,
Boost Coding Accuracy/Pay-Up,
Save Time, Reduce Stress
Presented by: Dawn Cloud, CPC, CMSCS, CHCI, CPOM
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CPT Coding for Non-Coders
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CPT 101
Presented ByDawn R Cloud, CPC, CMSCS,CHCI,
CPOM480-516-7728
Objectives
Basic navigation of the CPT-4 Understanding symbols Chapters and guidelines Appendix's Index
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CPT
What is CPT? Current Procedural Terminology is a medical code set that is
used to report medical, surgical, and diagnostic procedures and services.
What are the 3 categories of CPT? Category I: Procedures consistent with medical practice and
widely used Category II: Supplementary tracking codes to be used in
performance measures Category III: Temporary codes for emerging technology
How many sections is the CPT manual divided into? The CPT book is divided into 6 sections: E/M, Anesthesia,
Surgery, Radiology, Pathology and Laboratory, and Medicine
CPT
When do CPT codes get updated? CPT gets an annual update on January 1st of each year.
Who created CPT codes? CPT is currently identified by the Centers for Medicare and
Medicaid Services (CMS) as Level 1 of the Healthcare Common Procedure Coding System. The Current Procedural Terminology (CPT) was developed by the American Medical Association (AMA).
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Basic Navigation
Inside cover Places of Service Contents Introduction Illustrated anatomical and procedural review Evaluation and management tables Evaluation and management services 99201-99484 Anesthesia Guidelines 00100-01999
Basic Navigation
Surgery Guideline 10000-69999 Integumentary 10000-19499 Muscoskeletal 20005-29999 Respiratory 30000-32999 Cardiovascular 33010-39599 Digestive 40490-49999 Urinary 50010-53899 Male Genital System 54000-55920 Female Genital System 56405-59899 Endocrine System 60000-60699 Nervous system 61000-64999 Eye and Ocular Adnexa 65091-68899 Auditory System 69000-69999
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Basic Navigation
Radiology 70010-77084 Radiation Oncology 77261-77799 Nuclear Medicine 78012-79999 Pathology and Laboratory Guidelines 80047-0017U Medicine 90281-99607 Category II Codes 00001F-9007F Category III Codes 0042T-0504T
Basic Navigation
Appendix A Modifiers Appendix B Summary of Additions, deletions, and
revisions Appendix C Clinical Examples Appendix D Summary of CPT Add-on Codes Appendix E Summary of CPT Codes Exempt from
Modifier -51 Appendix F Summary of CPT Codes Exempt from
Modifier -63 Appendix G Summary of CPT Codes That Include
Moderate Conscious Sedation Appendix H Alphabetical Clinical Topics Listing Appendix I Genetic Testing Code Modifiers
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Basic Navigation
Appendix J Electrodiagnostic Medicine Listing of Sensory, Motor, and Mixed Nerves
Appendix K Product Pending FDA Approval Appendix L Vascular Families Appendix M Renumbered CPT Codes-Citations
Crosswalk Appendix N Summary or Resequenced Codes Appendix O Multianalyte Assays with Algorithmic
Analyses Appendix P CPT Codes That May Be Used For
Synchronous Telemedicine Services Index
Understanding Symbols
New Procedure code (Appendix B)
Substantially altered procedure descriptor
New and revised text other than procedure descriptors
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Understanding Symbols
+ Add on code (Appendix D)
Ø Modifier -51 exempt (Appendix E)
Pending FDA approval (Appendix K)
# Codes Out of Numeric Sequence(Appendix N)
Can be used to Report Telemedicine (Appendix P)
Understanding Symbols
Introductions
Bottom pages
Coding guidelines
Appendixes
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Codes Out of Sequence
Sometimes you may find procedure codes that are out of order in the code manual. Placing codes out of numerical order allows for clustering of similar procedures, and can help the medical coder find exactly the right procedure code. These out‐of‐sequence codes typically have a note instructing the coder to flip to the correct code elsewhere in the book.
Codes Out of Sequence
31254: Nasal/Sinus endoscopy, surgical with ethmoidectomy, partial, anterior
31255: Total(anterior and posterior)
#31253: Total(anterior and posterior), including frontal sinus exploration, with removal oftissue from frontal sinus when preformed
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Basic Rules
Parent Coding Indented procedures
Head to Toe Break down anatomy
RVU’s Which procedures pay less
Less invasive to greater degrees of invasive
Basic Layout of Chapters
Chapter Table of contents
Overall Coding Guidelines
Code specific guidelines
Anatomy/Illustrations
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Overall Surgery Guidelines
Services CPT Surgical Package Definition Follow-up Care for Diagnostic Procedures Follow-up Care for Therapeutic Surgical Procedures Supplied Materials Reporting More Then One Procedure/Service Separate Procedure Unlisted Service or Procedure Special Report Imaging Guidance Surgical Destruction
Code Specific Surgery Guidelines
Excision Benign Lesions 11400-11471
Definition Size Anatomic Location Repairs
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Code Specific Surgery Guidelines
Skin Lesion Removal: Before Your Procedure Biopsy. The doctor cuts out or shaves a small part of
the lesion. ... Excision. The doctor cuts out the entire lesion and,
often, some of the area around it. Cryosurgery. The doctor uses a very cold liquid or
special tool to freeze and destroy skin cells. Curettage. ... Electrocautery. ... Laser surgery. ... Mohs micrographic surgery.
Code Specific Surgery Guidelines
Muscoskeletal Also has codes for excision benign Lesions
Excision of subcutaneous soft connective tissue tumors
Excision of fascial or subfascial soft tissue tumors Definition Size Anatomic Location Repairs
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Code Specific Surgery Guidelines
10021: Fine needle aspiration; without image guidance
10022: Fine needle aspiration; with image guidance
60100: Biopsy Thyroid; percutaneous core needle
Appendixes
Appendix AModifiers-complete descriptions great for appeals
Appendix BChanges
Appendix CClinical examples
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Index
Main terms Resection Biopsy Drainage
Anatomical areas Hip joint Bladder Artery
Procedures Jejunostomy Arthroplasty Delivery
Surgical Name
Index
Example:
Fracture Distal Radius Fracture/radius/distal Radius/fracture/distal Smith/fracture
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Index
Example:
Hartman closure Hartman/closure Anastomosis/colorectal Colon/closure/stoma
Other Resources
ICD-10 HCPCS Coding Companions Coder’s Desk Reference NCCI Manuel Medical dictionary Google Netter’s CPT 3M Encoder Encoder Pro
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Questions?
Presented By:
Dawn R Cloud, CPC,CMSCS, CHCI,CPOM