Current Procedural Terminology Concept

Introduction. Steps involved in CPT Coding

• Current Procedural Terminology is a form of medical language.
• The process involves seven main steps encompassing (Landon & Mechanic, 2017).

  • A review of the report’s header.
  • An examination of the index in CPT codebook.
  • A scrutiny of documented report.
  • Development of selected preliminary code.
  • Auditing the guidelines.
  • Inquiring about the policies to eliminate redundancies.
  • The addition of necessary modifiers.
• The steps assist in medical information exchange (Landon & Mechanic, 2017).
• Different stakeholders use the medical code including;

  • Physicians.
  • Accredited organizations.
  • Health insurance companies.

Definition of Modifiers and the Utilization

• Modifiers provide more procedural information (Landon & Mechanic, 2017).
• It describes the performed multiple procedures.
• The element justifies necessity of an operation.
• Alterants quantify the participatory surgeons.
• The details foster payer’s decision, such as insurers.
• CPT modifiers encompass two characters.
• Types of the element enshrine alphanumeric or numeric.
• Characters are added at CPT’S end using hyphen (Wang, 2018).
• The functional code begins then informational one follows.
• The arrangement fosters effectiveness during review.
• Example is surgeon using 23140 code and -52 modifier.
• The code is indication of subtracted service
• Add-on codes demonstrate extra procedural work.
• The efficiency regards the integration with primary procedure.
• The process must be completed from the same doctor (Wang, 2018).

There are different categories of add-ons:

• Type I
• Type II
• Type III

  • Add-ons attribute completion of medical procedure.
  • An example is a surgeon operating a knee.
  • The Add-on entails the demand for an extra joint.
  • The validity enshrines two components:

    • The completion of process by one medical practitioner (Wang, 2018).
    • The combination of Add-on with primary surgery.

Types of Patients

There are five different types of patients.

The first type of client is passive-dependent:

• The individual prefers the doctor making all decisions.
• There is proficient trustworthy relationship (Geehr, 2017).
• The person views healthcare as scientific than artistic.

The second type of sick customer is independent-skeptical:

• The victim lacks sufficient trust on doctor.
• Patient is skeptic regarding doctor’s advice.
• The individual makes final decision.
• Healthcare perception is more artistic than scientific (Geehr, 2017).
• The client seeks consistency and expert opinion.

The third type of the ill personnel is intellectual-researcher:

• The victim shows eagerness to understand diagnosis.
• The mutual trust depends on evidence-base.
• The patient prefers doctor in prestigious institution.
• The personnel focuses on intellectualizing the condition.
• Medical practice is more scientific than artistic.

The fourth type of patient is expedient-flexible:

• The client features medical condition episodes (Geehr, 2017).
• The individual lacks interest in relationship with doctor.
• The sick character is cost-conscious.
• The patient lacks curiosity regarding diagnosis.
• The individual is accustomed to hospital procedures.

The fifth type of a patient is open-minded and exploratory:

• The personnel focuses on relationship building with practitioners.
• Healthcare perception regards a partnership (Geehr, 2017).
• Doctor’s preference of a flexible professional.
• The victim opts for alternative treatment.

References

Geehr, E.C. (2017). 5 patient types: Which are you? Everyday Health. Web.

Landon, B. E., & Mechanic, R. E. (2017). The paradox of coding: Policy concerns in the move to risk-based provider contracts. The New England Journal of Medicine, 377(13), 1211.

Wang, K. C. (2018). Standard lexicons, coding systems and ontologies for interoperability and semantic computation in imaging. Journal of Digital Imaging, 31(3), 353-360.