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Medical and Procedural Coding Information

Jan works for a busy general surgeon. She is in charge of billing and reimbursement for the practice. As part of her job, it is necessary for Jan to be able to accurately code any procedures done so the billing can be completed.

With newer procedures, Jan occasionally cannot find the correct code to match the procedure. She feels that the billing must be completed no matter what, so Jan simply looks for procedural code that is closest to the procedure performed and codes it as that procedure.

â-¦Is Jan dealing with codes that cannot be found properly? Why or why not?

â-¦How would this be handled differently if Jan were using current procedural terminology (CPT) codes that are not listed?
with references

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The CPT is updated annually in book form. Updated codes can also be found on the AAPC website (top link, although it is from last year). AAPC also offers webinars to familiarize coders with the new, updated, or revised codes (bottom link).

You cannot code directly from the main Index of the CPT. You must just use that as a reference and then look up the code in numerical order to make sure it is the correct code.

In the CPT there are codes that are awaiting approval. Those are in Appendix K and are noted with a lightning bolt symbol preceding the number.

Some codes are not in ...

Solution Summary

Information about medical and procedural coding. What to do if you cannot find a code and how to avoid fraud. How to code with newer, emerging technology.