Current Procedural Terminology - CPT is owned and maintain by American Medical Association (AMA). CPT is a proprietary code set, meaning that it is not available to public for free. The newly revised information of code set must be purchased, either in printed books or electronic format, from AMA. CPT lists the procedure and services performed commonly by physician across the country.
CPT code set is published annually in the late summer or early fall as both electronic data files and printed books. The release of CPT data files on the internet typically precedes the book by several weeks. In any case, January 1 is the effective date for use of the updated CPT code sets. The interval between the release of the update and effective date is considered the implementation period and intended to allow physicians and other providers, payers and vendors to incorporate CPT changes into their systems. The exceptions to this schedule of release and effective dates are CPT category III and vaccine product codes, which are release twice a year on January 1 and July 1 with effective dates for use six months later, and CPT category II codes. Changes to the CPT code set are meant to be applied prospectively from the effective date.
There are (3) three Categories of CPT codes
[Category I codes, Category II codes, Category III codes]:
1. CPT Category I codes - have 5 digits (with no decimals). Each code is listed with its descriptor, which is a brief explanation of a procedure. The codes are groups into six sections:
Evaluation and Management ............................................................................ 99201-99499
Here are the link for E/M Documentation Guidelines below:
Evaluation and Management Documentation Guidelines
E/M 1995 Guidelines
E/M 1997 Guidelines
Sample Common EM Codes
Surgery (find the 16 Subsections of Surgery in this web page............................... 10021-69990
Radiology (Including Nuclear Medicine and Diagnostic Ultrasound....................... 70010-79999
Pathology and Laboratory .................................................................................. 80048-89356
Medicine (except Anesthesiology) ...................................................................... 90281-99199, 99500-99602
2. CPT Category II codes - contains a set of supplemental tracking codes that can be used for performance measurement. These codes, which have alphabetic characters for the fifth digit, are optional (4 digits followed by the letter F) ; they are not paid by insurance carriers.
Example:
Composite Measures .....................(0001F-0015F) - ei, 0001F Heart failure assessed
Patient Management ......................(0500F-0575F) - ei, 0503F Postpartum care visit
Patient History ..............................(1000F-1400F) - ei, 1030F Influenza immunization status assessed
Physical Examination .....................(2000F-2060F) - ei, 2010F Vital Signs (TPR & BP) documented & reviewed
Diagnostic/Screening
Processes or Results.......................(3006F-3720F) - ei, 3014F Screening mammography results documented
and reviewed
Therapeutic, Preventive or
Other Interventions.........................(4000F-4400F) - ei, 4006F Beta-blocker therapy prescribed
Follow-up or
other outcomes ..............................(5005F-5200F) - ei, 5005F Pt counseled on self-examination for new or changing moles
Patient Safety ................................(6005F-6090F) - ei, 6020F NPO (nothing by mouth) ordered
Structural Measures ....................... (7010F-7025F) -ei, 7020F Mammography assessment category (eg, Mammography Quality Standard Act [MQSA], Breast Imaging Reporting Data System [BI-RADS], or FDA Equivalent categories)
3. CPT Category III codes -
The annual changes for Category I codes are released by AMA on October 1 and are in effect for procedures and services provided after January 1 of the following year. Category II and Category III codes are prereleased on the AMA website every six months. These codes can be used on their implementation date even before they appear in printed books.
Process of Assigning Correct and Accurate Procedure Codes:
1. The first step is to identify the procedures to be coded.
2. The second step is to research each procedure in CPT index.
3. The third step is to verify the possible codes in the main text, making sure the selection is accurate, and assign modifiers if needed.
4. The fourth step is to rank the codes to be reported for each day's services in order of highest to lowest rate of reimbursement. The actual order in which they were performed on a particular day is not important. For services on multiple dates, the earliest day is listed first, followed by subsequent dates of service.
For example:
Date Procedure Charge
07/17/2013 99214 $203
07/18/2013 43281 $375
07/18/2013 74250 $105
Wound Documentation Includes:
> Length
> Width
> Depth
> Tunneling (if present)
> Color of the wound tissue
One of the most accurate and effective assessment wound measuring tool that I found on the internet is NE1 WAT (NE1 Wound Assessment Tool) <<< - - - please visit this link for more details. Sample "Wound Description and Color Tissue" picture from NE1 WAT trademark. Click the image below for larger view:
I just want to emphasize the 16 Subsections of Surgery in this web page:
1. Surgery Integumentary System (10K Series) > Length
> Width
> Depth
> Tunneling (if present)
> Color of the wound tissue
One of the most accurate and effective assessment wound measuring tool that I found on the internet is NE1 WAT (NE1 Wound Assessment Tool) <<< - - - please visit this link for more details. Sample "Wound Description and Color Tissue" picture from NE1 WAT trademark. Click the image below for larger view:
