STUVIA 2024/2025
Medical Billing/Coding Ch 8
A listing of descriptive terms and identifying codes for reporting medical services and
procedures. It provides a uniform language that describes medical, surgica, and
diangostic services to facilitate communication among providers, patients, and
insurers. - ✔✔Current Procedural Terminology (CPT)
Services and procedures performed on patients:
*By providers in offices, clinics, and private homes
*By providers in institutional settings such as hsopitals, nursing facilities, and hospices
*When the provider is employed by the healthcare facility
*By a hospital outpatient department - ✔✔CPT codes are used to report:
Evaluation and Management
anesthesia
Surgery
Radiology
Pathology and Laboratory
%
Medicing
**Every American Soldier Reads Playboy Magazine** - ✔✔CPT Sections:
Procedures/services identified by a five-digit CPT code and desriptor nomenclature;
these are codes traditionally associated with CPT and oranized within six sections -
✔✔Category I codes
contain "performance measurements" tracking codes tht are assigned an alphanumeric
identifier with a letter in the last field (1234A) these codes will be located after the
Medicine section, and their use is optional. - ✔✔Category II codes
contain "emerging technology" temporary codes assigned for data collection purposes
that are assigned an alphanumeric identifer with a letter in the last field (0001T) -
✔✔Category III Codes
stuvia
, STUVIA 2024/2025
Most procedures and services are classified as this. They include a complete
description of the procedure or service. To save space, some descriptions are not
printed in their entirely next to a code number. Instead, an indented code appears
below a stand-alone code, requiring the coder to refer back to the common portion of
the code description that is located before the semicolon. - ✔✔Stand-alone codes
Codes exempt from modifier -51 reporting rules - ✔✔Appendix E
Identifies new prodedures and services added to CPT - ✔✔a "bullet" located to the left
of a code number..
Identifies a code description that has been revised - ✔✔A "Triangle" located to the left
of a code number ..
revised guidelins and notes (this symbol should not be used for revised code
descriptions) - ✔✔Horizontal triangles surround...
%
save space in CPT, and some code descriptions are not printed in their entirety next to
a code number. Instead, the entry is indented and the coder must refer back to the
common portion of the code description that is located before the semicolon. - ✔✔a
"semicolon" is used to..
identifies add-on codes (Appendix D of CPT) for procedures that are commonly, but not
always, performed at the same time and by the same surgeon as the primary
procedure. - ✔✔a "plus" symbol
identifies codes that are not to be used with modifier -51 - ✔✔The "forbidden" symbol
indicates a procedure that includes moderate (conscious) sedation - ✔✔The
"bullseye" symbol
the administration of moderate sedation or analgesia, which results in a drug-induced
depression of cnsciousness.
stuvia
Medical Billing/Coding Ch 8
A listing of descriptive terms and identifying codes for reporting medical services and
procedures. It provides a uniform language that describes medical, surgica, and
diangostic services to facilitate communication among providers, patients, and
insurers. - ✔✔Current Procedural Terminology (CPT)
Services and procedures performed on patients:
*By providers in offices, clinics, and private homes
*By providers in institutional settings such as hsopitals, nursing facilities, and hospices
*When the provider is employed by the healthcare facility
*By a hospital outpatient department - ✔✔CPT codes are used to report:
Evaluation and Management
anesthesia
Surgery
Radiology
Pathology and Laboratory
%
Medicing
**Every American Soldier Reads Playboy Magazine** - ✔✔CPT Sections:
Procedures/services identified by a five-digit CPT code and desriptor nomenclature;
these are codes traditionally associated with CPT and oranized within six sections -
✔✔Category I codes
contain "performance measurements" tracking codes tht are assigned an alphanumeric
identifier with a letter in the last field (1234A) these codes will be located after the
Medicine section, and their use is optional. - ✔✔Category II codes
contain "emerging technology" temporary codes assigned for data collection purposes
that are assigned an alphanumeric identifer with a letter in the last field (0001T) -
✔✔Category III Codes
stuvia
, STUVIA 2024/2025
Most procedures and services are classified as this. They include a complete
description of the procedure or service. To save space, some descriptions are not
printed in their entirely next to a code number. Instead, an indented code appears
below a stand-alone code, requiring the coder to refer back to the common portion of
the code description that is located before the semicolon. - ✔✔Stand-alone codes
Codes exempt from modifier -51 reporting rules - ✔✔Appendix E
Identifies new prodedures and services added to CPT - ✔✔a "bullet" located to the left
of a code number..
Identifies a code description that has been revised - ✔✔A "Triangle" located to the left
of a code number ..
revised guidelins and notes (this symbol should not be used for revised code
descriptions) - ✔✔Horizontal triangles surround...
%
save space in CPT, and some code descriptions are not printed in their entirety next to
a code number. Instead, the entry is indented and the coder must refer back to the
common portion of the code description that is located before the semicolon. - ✔✔a
"semicolon" is used to..
identifies add-on codes (Appendix D of CPT) for procedures that are commonly, but not
always, performed at the same time and by the same surgeon as the primary
procedure. - ✔✔a "plus" symbol
identifies codes that are not to be used with modifier -51 - ✔✔The "forbidden" symbol
indicates a procedure that includes moderate (conscious) sedation - ✔✔The
"bullseye" symbol
the administration of moderate sedation or analgesia, which results in a drug-induced
depression of cnsciousness.
stuvia
