INTRODUCTION
TO
CPT
(CURRENT PROCEDURAL
TERMINOLOGY )
MEDICAL CODING
•
Medical Coding is assigning codes to diagnoses and
procedures which help in financial reimbursement from
insurance companies and government agencies.
Medical coders use standardized codes to report
medical services and facilitate payment, these are :
1. PROCEDURE CODES : CPT-4
2. DIAGNOSIS CODES : ICD-9-CM
CPT :
CURRENT PROCEDURAL
TERMINOLOGY
INTRODUCTION
 CPT was developed and copyrighted by the American
Medical Association (AMA).
 It is updated and published annually in January.
 CPT is a listing of five-digit codes that identify services
and procedures performed by physicians in any setting
 CPT is divided into three categories of codes.
 Category I
 Category II
 Category III
CATEGORY I
Category I codes are the five-digit numeric codes
included in the main body of CPT.
Category I codes are broken down into six
sections :
1. Evaluation and Management (9 series)
2. Anesthesiology (0-series)
3. Surgery (1-6 series)
4. Radiology (7 series)
5. Pathology and Laboratory (8 series)
6. Medicine(9 series)
CATEGORY II
They are alphanumeric and consist of four digits followed
by the alpha character 'F.'
The use of these codes is optional and are not a substitute
for Category I codes.
Example :
0002F Tobacco use, smoking, assessed
0003F Tobacco use, non-smoking, assessed
CATEGORY III
They represent temporary codes for new and emerging
technologies
The Category III codes are five characters long, with
four digits followed by the letter 'T' in the last field
Example : 0012T Arthroscopy knee, surgical,
implantation of osteochondral graft(s) for treatment of
articular surface defect, autografts.
MODIFIERS
A modifier will modify a service / procedure or an item under certain
circumstances for appropriate reimbursement
Examples :
Modifier -50 Bilateral Procedure
Modifier -51 Multiple Procedures
Modifier -52 Reduced Services
Modifier -53 Discontinued Procedure
Modifier -59 Distinct Procedural Service
Modifier -62 Two Surgeons
HUMAN ANATOMY :
1. BODY PLANES AND SECTIONS
2. BODY CAVITIES
3. ABDOMINAL REGIONS
BODY CAVITIES
ABDOMINAL REGIONS
QUESTIONS
Q. This is a part of the inner ear:
a. vestibule
b. malleus
c. incus
d. stapes
Q This is the area behind the cornea:
a. anterior chamber
b. choroid layer
c. ciliary body
d. fundus
Q. Which septum divides the upper two chambers of the
heart?
a. Myocardium b. Intraventricular c. tricuspid d.Interatrial
Q. This is the first portion of the small intestine:
a. jejunum
b. ileum
c. duodenum
d. cecum
Q. Complete the series: Pulmonary, Aortic, Mitral and
valves of the heart.
a. Tricuspid
b. Superior vena cava
c. Carotid
d. Atrium
Q. What part of the neuron receives signals?
a. Myelin sheath
b. dendrites
c. axon
d. cell body
------- are
CPT Questions:
Q. CPT has been developed and maintained by
a. AMA(American medical association)
b. CMS
c. The Cooperating Parties
d. WHO
Q. 40. A patient develops a large subcutaneous hematoma after
surgery and is returned to the OR during the global period for
drainage. Which modifier should be added to the CPT code?
a. 59
b. 58
c. 78
d. 79
Q.A surgeon performs a diagnostic laparoscopy followed by a
laparoscopic nephrectomy (including partial ureterectomy). How should
the physician report these services?
a. 50546
b. 49320, 50546-51
c. 49320
d. 50549
Q. The anesthesiologist performed MAC (monitored anesthesia
care) for a patient undergoing an arthroscopy of the right knee.
Code the anesthesia service.
a. 01382-AA
b. 01382-AA-QS
c. 01400-AA
d. 01400-AA-QS
Q. How should you report a deep biopsy of soft tissue of the thigh
or knee area?
a. 27323
b. 27324
c. 20206
d. 27328
Q. A male patient presents for bilateral mastectomy with a
diagnosis of gynecomastia. Choose the correct procedure and
diagnosis codes.
a19303 x 2, 611.8.
b. 19301-50, 611.4
c 19300-50, 611.1
d.19304 x2 ,611.1
THANK YOU
ODYSSEY INFORMATICS
YMCA