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06:57
By Patty Goff


Medical billing can be a complicated endeavor. There are a high number of illnesses, surgeries and much information to remember. The person who functions in this medical position will use the Current Procedural Terminology or cpt codes, on a regular basis.

There is a panel of experts who oversee maintenance of the medical code under the direction of the American Medical Association. It is called the CPT Editorial Panel. It is copyright protected by the AMA.

This code was created to make clear what was administered to each patient in the communications transmitted from one medical department to another. Separate ones identify diagnoses, surgeries and all other medical processes.

The ICD-10 coding system is used to specify what a patient is being treated for. The three types of CPT codes are used to differentiate among all the procedures, care services and surgeries. There are three separate categories, each having separate sections to cover various similar services. Some examples place in Category I are outpatient, Nursing Home and Home Health Care Nursing.

They become very specific. One is used for any administration of anesthesia. A separate set of numbers is used to refer to each body part that is operated on. Examples include head, back, extremities, which have separate numbers.

Individual numbers assigned to surgical services may include pelvic, reproductive system and auditory system. To make the billing very specific, a cochlear implant surgery is classified under auditory system. Billing is rendered less complicated when used in the bills sent out to the patient.

Radiology includes diagnostic ultrasound, radiation oncology and mammography. The mammogram is most often a routine check for breast cancer. It is administered by a nurse and read by a physician.

Pathology and laboratory are another category. Included are drug tests, evocative suppression testing and the simple urinalysis administered as part of any routine exam in the physicians office. Complicated testing includes hematology and coagulation, transfusion medicine and the postmortem anatomic pathology.

The ones for the category named medicine include routine vaccinations, administering those immunizations and treatments for kidney disease, which are transfusions to clean the blood. It is dialysis that maintains the patients life while they wait for a kidney transplant. After that, if successful, they will no longer require dialysis treatments.

Specialists also fall under the class of those used for medicine. Some specialties include otorhinolaryngology, psychiatry and cardiology. The cardiologist is known as the heart doctor and the otorhinolaryngologist is, in laymans terms, an ear, nose and throat doctor.

They include a letter of the alphabet to indicate they belong in Category II. There will be four numbers and then a letter of the alphabet. There are eleven Category II codes that include diagnostic screenings, taking a patient history and physical examination.

Under Category III you will find the ones for psychotherapy and other counseling services. From time to time codes are retired. This year will not see a change in the psychological testing code. Each year they are re-evaluated.

It is true that CPT is a copyright protected registered trademark belonging to the American Medical Association. However, its use is not limited to that organization. It is used by other health care organizations. Some examples are the Centers for Medicare and Medicaid, and the Federal Register. Each pays a licensing fee to entitle them to utilize the code.




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