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CPT

Current Procedural Terminology

TermDefinition
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