CPT 101: How-to Coding for Everyone · 2018. 12. 15. · CPT Coding for Non-Coders 2 CPT What is CPT? Current Procedural Terminology is a medical code set that is used to report medical,

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

www.codingleader.com 1

CPT 101

Presented ByDawn R Cloud, CPC, CMSCS,CHCI,

CPOM480-516-7728

[email protected]

Objectives

Basic navigation of the CPT-4 Understanding symbols Chapters and guidelines Appendix's Index



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).



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



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



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




+ 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)


Introductions

Bottom pages

Coding guidelines

Appendixes



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



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



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




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.


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




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



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



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



Questions?

Presented By:

Dawn R Cloud, CPC,CMSCS, CHCI,CPOM

[email protected]

Documents

CPT 101: How-to Coding for Everyone · 2018. 12. 15. · CPT Coding for Non-Coders 2 CPT What is CPT? Current Procedural Terminology is a medical code set that is used to report medical,