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CPT
Current Procedural Terminology
| Term | Definition |
|---|---|
| New Patient: Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: | 99201-New Patient 1. A problem focused history; 2. A problem focused examination; 3. Straightforward medical decision making. |
| New Patient | Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem (s) and the patient's and /or family's needs. |
| A CPT procedure or service code that contains a semicolon is divided into two parts; the description ------ the semicolon and the description --------the semicolon. | before, after |
| The words before the semicolon are considered the -----------in the code descriptor. | common portion |
| The indented descriptor is dependent on the | proceeding common portion |
| --------necessary to report the main code (for example, 00160) when reporting the indented codes (for example 00162 or 00164). | It is not |
| +Add-on Code, they always accompany specific primary procedure codes | An add-on code is; Never listed as the primary service; Never listed as the only CPT Never reported with modifier 51 |
| The number of times a single CPT code is reported. | Units: eg, 11300 Shaving of epidermal or dermal lesion, single lesion, etc. ie, the provider shaves 3 epidermal lesions on the patient's right leg; each lesion measuring less than 0.5 cm. ll300 x3. indicating three units of 11300 are being billed. |
| This phrase indicates the code is reported only once whether it refers to single procedures or lesions or refers to multiple procedures or lesions as described in the code descriptor. | Single or Multiple (example: 20552 injection (s); single or multiple trigger points (s), 1 or 2 muscle (s) In this example if the provider injects one trigger point in one muscle, 20552 is reported. |
| Multiple trigger points, | If the provider injects three trigger points in in one muscle, 20552 is still reported once because the coded descriptor states single or multiple trigger points. |
| The CPT index is alphabetized with main terms organized by ----? | condition, procedure, anatomic site, synonyms, eponyms, and abbreviations |
| NCCI | CMS implement the National Correct Coding Initiative (NCCI) to promote correct coding methodologies and to control improper assignment of codes that results in inappropriate reimbursement |
| GPCI | Geographic practice cost index (this is used to realize the varying cost based on geographic location) |
Created by:
MissMeeMee
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