Medical Billing and the CPT Codes

Monday, December 17, 2007

By definition medical billing is the process of submitting and following up on claims to insurance companies in order to receive payment for services rendered by health care providers. This is a common process that must be followed by all types of organizations and involves the interaction between the insurance company and the health provider. The patient record must contain a summary of treatment and demographic information related to the patient. What are the various types of details in a patient record? They include,

Personal information
Nature of the illness
Examination details
List of medication
Diagnosis details
Suggested treatment

Now the actual level of service that is given is evaluated for the sake of billing and is translated into a five digit code called CPT (Current Procedural Terminology). The CPT code set accurately describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes. The current version is the CPT 2007. The present CPT code set is maintained by the AMA (American Medical Association) and CPT is a registered trademark that prevents the free use and distribution of these codes.

There are three types of CPT. They are,