How Do You Read Medical Procedure Codes?


Quick Answer

To read medical procedure codes, look at the five-numbered Current Procedural Terminology, or CPT, code on your bill. Visit the American Medical Association website to search for the code and find out what it means, recommends the AARP.

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Full Answer

When you receive a bill or explanation of benefits from your doctor or insurance company, look for a five-digit code associated with each procedure, suggests the AARP. Use this information to track your claims, compare what your practitioner is billing your insurance company to what your insurance company allows and ensure you are being billed properly for your service.

The AARP says that if the medical procedure code you obtained from your doctor does not match what your insurance company says it has been billed for, call your doctor's office to get an explanation. Whenever you get a bill or statement from your doctor's office with a medical procedure code on it, copy the code and put it into the CPT search engine on the AMA website. This website tells you the name of the code, along with information about the specific procedure. If a practitioner did not perform the procedure specified by the CPT code, contact the practitioner or your insurance company.

Look at how many units a practitioner bills you for with every CPT code, notes FAIR Health. If you are billed for more than one unit on a CPT code, ask your practitioner for clarification. Some CPT codes are legally billed for more than one unit, but this depends on the procedure.

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