CPT Codes Process

About Current Procedural Terminology (CPT) Codes

Most physicians and healthcare professionals are familiar with current procedural terminology, or CPT, codes. But, here is a little more detail to give you a deeper understanding of why these are critically important to the financial health of your practice.

CPT codes are medical codes that are updated by the CPT Editorial Panel–a group of physicians, American Medical Association (AMA) members and third-party payer representatives who are authorized by the AMA Board of Trustees revise, update or modify CPT codes, descriptors, rules and guidelines.  

Each code consists of five digits that are designed to designate the type of medical service administered by a healthcare provider. There are roughly 7,800 CPT codes currently in use, however, this number can vary when new codes or variations to current codes are released each October.

Why CPT Codes Are Important

CPT codes are used to indicate what services have been rendered to patients. The codes are then sent to third-party payers (insurance providers) to claim payment for the healthcare services provided. Simply put, CPT codes are central to the financial health and billing process for private medical practices, healthcare organizations, and insurance providers.

Categories of CPT Codes

CPT codes are divided into the following categories:

Category 1
Category 2-4
Category 3-4
Strictly numerical; Categories for evaluation and managementNumerical digits followed by the letter “F”Numerical digits followed by the letter “T”
Anesthesia CodesComposite MeasuresEmerging Technology
Surgery CodesPatient Management
Radiology CodesPatient History
Pathology & Laboratory CodesPhysical Examination
Medicine CodesDiagnostic/Screening Process
Therapeutic, Intervention and Preventative
Follow-Up
Patient Safety
Structural Measures

 

CPT Coding Process for Physicians and Healthcare Providers

Due to the complexity of CPT codes, physicians and healthcare providers to evaluate their current medical coding and billing processes to identify areas where optimization is possible. Ask yourself the following questions at the end of each quarter:

  • What does the CPT coding process look like at your office?
  • How efficient is this process?
  • Is your office staff qualified and certified to complete CPT coding tasks?
  • Are you receiving all the claims revenue that you are due?

Your CPT coding process should include accurate coding and claims management following the rendering of any services provided. There should also be a process in place to implement the annual revisions by the CPT Editorial Panel into your system.

This process can not only be complicated and difficult for practice administration to accomplish successfully but also extremely time-consuming.

Why You Should Outsource CPT Coding to Certified Coders

Instead of managing the CPT coding process in-house, consider outsourcing this process to certified coders so that you can shift your focus from administrative tasks back to delivering exceptional patient care.

Applied Medical Systems (AMS) provides certified billing and coding services to medical practices and medical providers across the country. Based in Durham, North Carolina, our highly-qualified team of certified billers and coders can completely cover your medical billing and coding process with 97% or greater accuracy.

Our practice management consultants can also work with you and your staff to make sure your CPT coding workflow is as efficient and accurate as possible.

Contact us today to learn more about how we can help you increase profitability, increase efficiency and increase compliance.