To reduce delays and to enhance compliance in health care reimbursement, it is important to understand the Current Procedural Terminology (CPT) system. This system is useful in the identification of procedures that need to be performed to any out patient. To reduce the same code being used to identify different reimbursement, it is important to constantly revise the CPT codes every year.
Also most of the procedures have to be assigned to CPT regular code; for expensive procedures, non frequent and specialized on billing mechanism should be provided. The code ending with 99 is mostly given to these procedures. However, the use of this code should be restricted because they are subject to review in the medical field by the carrier (Voorhees, 2010).
The use of CPT system is important in health care delivery especially those sectors that receive reimbursements from Medicaid and Medicare. This assists in the provision of information in medical service billing and in the identification of services that a particular patient receives (Filler, 2004, pp 875-6).
Also through the series of 80000, laboratory services can be identified. This is the procedures that need to be performed in the reimbursement for out patients which is crucial information needed by Medicaid and Medicare regulations.
By the use of level III codes, intermediaries and carries can simplify transition by cross-referencing them to the codes of CPT. For inpatient service, certain regulations of payments that need to be reimbursement are done according to the required fee of the diagnosis to other related groups (King, Sharp & Lipsky, 2001, pp 184-92).
CPT coding affects the income from the outpatient market. This is because Medicaid payment tend to be much lower than that of Medicare, but regardless of the status of the provided which can be POL, laboratory and the hospital, reimbursement from Medicaid and Medicare will always be the same (Manchikanti, 2001, pp 381-99).
Voorhees (2010)Mistakes to avoid in CPT coding and billing: understanding the Current Procedural Terminology system helps enhance compliance and reduce delays in reimbursement". Medical Laboratory Observer. Retrieved from http://findarticles.com/p/articles/mi_m3230/is_n6_v23/ai_10927319/
On September 21st 2010
Filler, B.C., Coding and reimbursement in sports medicine. (2004) South Med J. 97(9),875-6.
King, M.S., Sharp, L., & Lipsky M.S., (2001) Accuracy of CPT evaluation and management coding by family physicians. J Am Board Fam Pract. 14(3),184-92.
Manchikanti, L., (2001) Role of Correct Coding for Interventional Techniques. Pain Physician. 4(4). 381-99.