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You are on a job interview and need to explain the format of the CPT manual....

You are on a job interview and need to explain the format of the CPT manual. How would you do that?

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Ans) Current Procedural Terminology (CPT) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations.

- CPT codes are of primary importance for a few different reasons: They are used by insurers to determine the amount of reimbursement a practitioner will receive under your hea galth insurance coverage (and ultimately how much of the bill you will be left responsible for).

- Each procedure or service is identified with a five-digit code. The CPT manual is updated annually by the American Medical Association (AMA) and the pain management professional specialty societies contribute to CPT code development and maintenance. There are extensive service and procedure coding requirements published in the CPT manual. Providers are responsible for knowing how to accurately report, and document, CPT codes for the services rendered.

There are three categories of CPT codes. Category I CPT codes describe a procedure or service identified with a five-digit numeric CPT code and descriptor nomenclature; these are considered the “usual” CPT codes and are widely accepted by third party payors.

Category II codes, five-digit codes with four numbers and ending with the letter “F”, are intended to facilitate data collection on positive health outcomes and quality patient care. Category III codes, five-digit codes with four numbers but ending with the letter “T”, facilitate data collection on and assessment of, new services and procedures and are used to report procedures that do not have a Category I code. Payors require a valid Category I and/or Category III code(s) for payment consideration.

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