Introduction

The universal language of healthcare

What are CPT codes?

Categories of CPT codes

Importance of performance measurement tracking

Emerging and experimental services

The significance of accurate CPT coding

Keeping CPT codes updated

Revenue integrity and its importance

Cpt Codes Are Updated Once a Year

What a Cpt Code Is

Cpt Codes

Levels of Service Codes

Diagnosis Codes

Incorrect Coding

Codes Are Used by

+ Plus = Add-On Code

Appendices of CPT

Notes

Two Types of Codes

What is CPT Coach?

Practice Plan

Stuck Points

Learned Section

Worksheets

Short Assessments

Reminders

Sharing your work

Finding support

Intro

CPT Code 99201

CPT Categories

CPT Code Structure

What Does CPT Not Cover?

Examples of CPT & HIP Codes

Dental Services

Office Visits

Rehab Services

Conclusion

Welcome

Incision and Drainage

Coding Example

Coding Practice Question

Parenthetical Guidelines

Coding Challenge

CPT Coding Example

Outro

Why Use Codes? ► Nomenclature for audiology and speech-language pathology services varied from facility to facility until codes unified Coding became universal in U.S. when payers, especially Medicare, required them Common language among providers, third party payers, and benefits administrators

Purpose and Definition Purpose of the coding systems - standardize descriptions of procedures, names of diagnoses, and names of items/supplies Definition of coding - process of assigning numeric or a combination of numeric and alpha values to medical services

CPT Codes Each code is designated by 5 digits and represents a distinct procedure CPT codes are used for billing, data analysis of individual procedures, and insurance coverage decisions Each code must represent a procedure that is not "experimental" or investigational

Modifiers Modifiers are two-digit numbers preceded by a hyphen that are added to CPT codes to describe unusual circumstances Use of a modifier means that the protocol for the procedure did not change, but there was something unusual about the circumstances under which the procedure was performed Documentation should always reflect why a modifier was used

Examples of Modifiers (cont.) -59 means distinct procedural service: this modifier is used when two procedures are reported on the same date that are not typically performed together in a single patient visit, but are appropriate under the circumstances -76 means procedure performed more than once per date of service by same provider: this modifier is used when the procedure is repeated in its entirety by the same provider on the same date of service

How Are Procedures Valued? Reimbursement formula has 3 components

How Are the Procedures Valued? Survey conducted asking participants to compare professional component of the surveyed code to professional component of other established procedures. Relative value of surveyed code established on basis of other procedures of similar difficulty and time. Result is a Relative Value Unit (RVU), a non-monetary value that ranks the time and intensity of the work effort. Final value established by an American Medical Association (AMA) Committee called the AMA/Specialty Society RVS (Relative Value Scale) Update Committee or RUC

What Happens to the Code When a Relative Value is Established? The RVU recommendation goes from the AMA committee to the Centers for Medicare and Medicaid Services (CMS) CMS can: Accept the recommendation and establish a dollar value for

How are New CPT Codes Created? Anyone can submit a code proposal to AMA AMA will post the proposal so that appropriate member organizations have it available for review The proposal is then considered at an AMA CPT Editorial Panel meeting with two of the panelists presenting their reviews and recommendations ► If the proposal is accepted it is forwarded to the RUC for valuation

Please proceed to... Module Two: International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)

2024 Cpt Codes

Immunization

Changes with Smallpox Vaccines and Monkey Pox

Category Three Codes Short Descriptions

Appendix Ai

Assistive Classification

Three Levels of Autonomous

Physician Involvement

Modifier 93 a Synchronous Telemedicine Service Rendered via Telephone

Exchange between the Physician and the Patient

What will I learn in this video?

2023 Final Rule Updates to Annual Wellness Visits

Types of Annual Wellness Visits and CPT Codes

Initial Preventive Physical Examination (IPPE) CPT Code G0402

Initial Annual Wellness Visit CPT Code G0438

Subsequent Annual Wellness Visit CPT Code G0439

Advanced Care Planning (ACP) CPT Code 99497

FQHC AWV CPT Code G0468

AWV CPT Codes Next Steps