Adding and editing procedure (CPT) codes

A CPT code is a medical billing code that can be cross-coded with an ADA Procedure Code to bill a medical insurance carrier for that procedure. You can add and edit a CPT code as needed.

To add or edit a CPT code

1.   From the File menu, point to Codes and Lists > Medical Codes, and then click Procedure (CPT) Codes.

The CPT (Medical Procedures) Code Table window appears.

2.   Do one of the following:

·        To add a CPT code, click Add.

·        To edit an existing CPT code, select a code, and then click Edit.

Tip: To quickly locate a CPT code, select whether you want to search by code or description, and then begin typing a code or description in the Search field. The first matching CPT code is selected in the list.

The Edit CPT Code dialog box appears.

Note: At the bottom of the Edit CPT dialog box, the number next to Posted allows you to see, at a glance, how many times an existing CPT procedure code has been posted.

3.   Set up the following options:

·        Code - Type the CPT code. If you are editing an existing CPT code, you cannot change this code. This field has a limit of five characters.

·        Insurance Code - Type the code that you want to use to identify the CPT code. The insurance code can be the same as or different from the CPT code. This field has a limit of five characters.

·        Description - Type the description for the CPT code.

·        Fee Range - Type the starting and ending amounts for the fee schedule that pertains to the procedure in a $$$,$$$.$$ format.

·        Global Surgical Package - Clear the check box to specify the number of days of follow-up treatment that is covered under the code without additional billing, and then select the number of Follow Up Days: 0, 7, 14, 30, 60, 90, or 120.

·        Assistant surgeon allowed - Select this check box if an assistant surgeon is permitted to assist with this procedure.

·        Defaults

·        ICD-10 and ICD-9 Dx. Code - Next to ICD-10 Dx. Code, click the Search button  to select and paste in a default diagnosis code (consisting of one ICD-10 code and/or one ICD-9 code). Click the Remove button to remove any previous selection.

·        Modifier - Click the Search button to select and paste in a default medical modifier code. Click the Remove button to remove any previous selection.

·        Type - Select a default service type.

·        RVUs - Enter the RVUs and Units/Minutes to set the default time values that will be used when scheduling an appointment for the procedure.

·        Modifier - Specify whether the time value specified is in units (UN) or minutes (MJ).

·        Pre-authorization

·        Phone - Select this check box if you prefer the pre-authorization to be completed over the phone.

·        Written - Select this check box if you prefer the pre-authorization to be completed on a written form.

4.   Click OK.

 

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