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CPT Coding Tips From the Experts

CPT (current procedural terminology) coding is a critical component to medical billing. Accurately indicating the level of patient care (i.e. complexity of an office visit) and the medical procedures performed will result in fewer insurance denials and reviews. Simple tips from the experts can help coders to avoid feeling overwhelmed by the daunting amount of codes in the CPT system.

  1. Current CPT Code Book

    • According to AMA (American Medical Association) guidelines, a new CPT code book is issued every year. Having a current copy is probably the most important tool in accurately coding patient care. Codes change, are added and removed in each new edition. Having the most up-to-date version of the CPT code book will deter mistakes and holdups with insurance companies and will help prevent denied claims. Read the introduction and requirements included in the CPT coding book to stay current on changes and modifications to the coding system. The book will usually outline important changes clearly to help with any necessary coding transitions.

    Focus On Most Used Codes

    • Medscape.com says most medical practices or departments use only use about 25 CPT codes 95 percent of the time. General practitioners will routinely use codes for established patient office visits and immunizations, while an ENT (ear, nose and throat specialist) will use codes for the placement of ear tubes or sever sinus issues. Codes will repeat frequently for patients of the same medical office. Becoming familiar with the most used codes cuts down on information that has to be stored in your immediate memory. As a result, only seldom-used codes must be looked up and verified.

    Update Billing Sheet Every Year

    • Since there is a new CPT code book issued every January, it only makes sense to update the billing sheet every year as well. Medical billing professionals and publishers of CPT coding books recommend to take some time to go through each CPT code on the pre-printed bill and make changes when necessary. Insurance companies usually offer a 90-day grace period for the use of old codes but it can slow down the payment process. Billing with the updated codes immediately will keep the payment and collection process running seamlessly.

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