How Do You Determine CPT Codes for Billing?


Quick Answer

Health care providers, billing and coding staff choose Current Procedural Terminology, or CPT, codes to use when billing according to guidance found in the CPT Coding Manual published by the American Medical Association, notes Mayo Medical Laboratories. CPT codes uniformly describe medical, surgical and diagnostic services, according to the AMA.

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Full Answer

Each CPT code is a numeric or alphanumeric set of digits that corresponds to a specific procedure or service provided by a health care provider or related professional, according to About.com. There are thousands of codes to choose from, and proper billing and reimbursement of medical claims depends on correct coding. Medical coding is a specialized profession, and medical coders are trained on how to choose the correct CPT code.

Certain professions tend to use specific sections of the CPT codes. For example, diagnostic radiology services are found in the 70,000 series, notes McKesson. Additional diagnostic and imaging-related procedures are found in the 22,000 series, which includes imaging guidance and any associated radiological supervision and interpretation.

Selecting the correct CPT code to use requires knowing the current version of the codes. For example, the 2015 version of the CPT added 226 new codes, deleted 147 codes and revised 129 codes, according to McKesson.

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