Discussion: Describe CPT coding

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HIM M131Week One

Discussion: Describe CPT coding

Using Chapter 3 of your text as your reference, in an organized format, describe CPT coding. Include information about HCPCS, and identify the six main sections of the CPT classification system that has coding guidelines for the use of codes within that section. Explain how CPT codes are different from ICD procedure codes.

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Discussion: Describe CPT coding
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Part 1: Describe the hospital inpatient prospective payment system (MS-DRGs) including what determines the MS-DRG and the relationship to ICD-10-CM diagnosis codes. Part 2: What is the Uniform Hospital Discharge Data Set (UHDDS)? How does it relate to medical coding? Part 3: Discuss the coding professional’s role in the revenue cycle and the effect coding has on reimbursement. Part 1: MS-DRGs was adopted in 2008, this was the most drastic revision in DRG System in 24 years. The goal of the new system was to improve Medicare’s ability to recognize the severe illness in its inpatient hospital payments. The new system is projected to increase payments to hospitals for services provided to the sicker patient and lower payments for treating less severely ill patients. There are up to three levels of severity in the MS-DRGs that reflect the differences in the patient’s condition based on the additional diagnoses codes: 1. MS-DRGs with major complication or comorbidity (MCC), which reflect the highest level of severity. This reflects the sickest patient with the highest level of severity and requires additional. Discussion: Describe CPT coding.

Categories and Examples

There are several , including:

  • Category I: Devices and drugs, including vaccines
  • Category II: Performance measures and quality of care
  • Category III: Services and procedures using emerging technology
  • PLA codes, which are alpha-numeric CPT codes used for lab testing

Here are some examples:

  • 99214 may be used for an office visit
  • 99397 may be used for a preventive exam if you are over 65
  • 90658 indicates a flu shot
  • 90716 may be used for chicken pox vaccine (varicella)
  • 12002 may be used when a doctor stitches up a one-inch cut on your arm

. That is, one code describes a number of aspects of care that are performed in combination.

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