Standard

Posted. 02/2005

MAS 153 – Physicians’ Procedural Coding

Course Description

Provides the knowledge and skills to apply the coding of procedures for billing purposes using the Physicians’ Current Procedural Terminology (CPT) manual. Topics include: format of CPT manual, CPT manual coding guidelines, and coding using the CPT manual.
Competency Areas:	Hours
Format of CPT Manual	Class	3
CPT Manual Coding Guidelines	D. Lab
Coding Using the CPT Manual	P. Lab/O.B.I.
	Credit	3
Prerequisite: MAS 151
Corequisite:

Course Guide

Competency	After completing this section, the student will:	Hours
		Class	D. Lab	P. Lab/ O.B.I.
FORMAT OF CPT MANUAL		5	0	0
Purpose	Explain the purpose of the Physician’s Current Procedural Terminology (CPT) manual
Sections	Name the six sections of the Physician’s Current Procedural Terminology (CPT) manual presenting procedural code numbers.
Descriptions	Explain the format of the terminology descriptions contained in the CPT.
Any section use	Explain the unrestricted specific specialty group use of a CPT code.
CPT MANUAL CODING GUIDELINES		10	0	0
Sectional guidelines	State where the guidelines for each coding section of the CPT are located
Stared procedure	Explain the purpose of the star symbol used in the CPT manual
Modifier	State the conditions under which modifiers are used to indicate the recipient of a report prepared using the CPT
Unlisted procedure	Explain the method for handling a procedure not found in the CPT manual
Code changes	State the symbols used in the CPT manual which reflect code number changes.
Anatomic site	Discuss the method of locating a CPT procedure when the anatomic site is given.
Eponyms	Discuss the method of locating a CPT procedure when the eponym is known.
Other media	Discuss the various media forms which are available to present CPT data.
Commonly used terms	State the location within the CPT manual for commonly used terms dealing with the evaluation and management (E/M) section.
Levels of E/M services	State the components used to determine levels of E/M services listed in the CPT manual.
Presenting problems	Name the types of presenting problems which are covered in the CPT.
Time listing	Discuss the method used to determine the time notations given in the CPT manual.
Selecting a level	Name the steps involved in using the CPT manual for selecting a level of E/M service.
Physical status modifiers	Give the modified number and its description of each of the anesthesia modifiers.
Subsection information	State the CPT manual location for subsection information dealing with surgery procedures.
Unlisted surgery procedures	State the fourth and fifth position numbers used in the CPT manual to indicate an unlisted surgical service or procedure.
Radiological modifiers	Discuss circumstances in which modifier numbers are added to the radiological CPT manual code.
Pathology and laboratory	State the pathology and laboratory subsections as found in the CPT manual guidelines.
	Give examples of modifiers used in the pathology and laboratory section of the CPT manual.
Materials supplied	State the CPT manual medicine section code used to identify materials supplied by the physician.
CODING USING THE CPT MANUAL		15	0	0
Coding patient records	Use simulated patient record data and the CPT manual to determine the numerical code for examples of physicians’ services and procedures that apply to each major section of the manual.

Suggested Resources

Books:

Bayes, Nenna L. (2002). Medical Insurance A Guide to Coding and Reimbursement. New York: Glencoe McGraw-Hill.

Buck, Carol J. (2004). Step-By-Step Medical Coding, 5^th Edition. St. Louis, MO: Saunders.

Buck, Carol J. (2004). Saunders 2004 ICD-9-CM, Volumes 1, 2, and 3 and HCPCS Level II. St. Louis, MO: Saunders.

Newby, Cynthia (2002). Medical Insurance Coding Workbook for Physician Practices. New York: Glencoe McGraw-Hill.

Current Edition of CPT 4 Coding Manual.

FA Davis Taber’s Cyclopedic Medical Dictionary, 19^th Edition.

Fordney, (2002). Insurance Handbook for the Medical Office Student Workbook, 7^th ed.

Diamond (2001). Mastering Coding: Tools, Techniques, and Practical Applications, A Worktext

Buck, 2002 ICD-9-CM, Vol. 1, 2 & 3 & 2002 HCPCS with Official Coding Guidelines, Suanders.

Covell (2002). Coding Workbook for the Physician's Office, Delmar.

American Medical Association (2005). CPT 2005.