Ch 4 Flashcards
(18 cards)
CPT Category 1 codes
5 digit numerical codes used for reporting and reimbursement.
CPT category 2 codes
Optional tracking codes in alphanumeric format with the last character being F. May be reported in addition to Cat 1 codes.
CPT category 3 codes
Temporary codes for emerging technology, services, and procedures. Alphanumeric with the letter T in the last position. Can be reported alone without a Cat 1 code.
Semicolon ;
Code is divided into 2 parts, the description before and after the semicolon. The words before it are the common procedure, the indented descriptor is dependent on the preceding.
Add-on codes +
Some procedures are commonly carried out in addition to a primary procedure, codes must be used with their specified primary procedure.
Bullet point
Indicates new procedures/services added to the CPT book
Triangle
A code description has been revised.
Opposing horizontal triangles
New or revised guidelines/instructions.
Circle with slash/Forbidden
Modifier 51 exempt codes
Lightning bolt
Vaccines pending FDA approval.
Pound #
Resequenced codes that are out of numerical order.
Star
Codes which can be reported when using synchronous telemedicine using both audio and video telecommunication.
Speaker/audio
Reported when telemedicine services are furnished using audio only communication.
Cat 1 CPT sections
Organized by anatomic location, procedure, condition, or descriptor subheadings.
Sequencing codes
When reporting multiple CPT codes, sequence the codes from highest to lowest relative value.
Global package
Payment for surgical procedures includes a standard package of pre-op, intra-op, and post-op services. Follow-up care only includes services usually part of the surgical services.
Global days for surgery
The pre-op period for major surgery is 1 day with 90 days post-op. The pre-op period for minor surgery is the day of the procedure with a 0-10 day post-op.
HCPCS
Covers codes for medical equipment, devices, medication, transportation services, etc.
