CPT® Medicine Coding Explained for CPC & CCS-P Exams

Thank you, Mrs. J for those great

instructions. And students, it's time

for us to move on to the medicine

section. And the medicine section covers

a 90,000

90,281

to 99,67

series.

So, medicine section has got a lot of

guideline. It is one of one of the

biggest chapters and it has lots of

guidelines which we need to know. So

know the rules. What are they? Let's

review some of these guidelines.

Let's look into the add-on codes. Some

of the listed procedures are commonly

carried out in addition to the primary

procedures performed and all the add-on

codes found in the CPT book are exempt

from the multiple procedure concept.

They are exempt from the use of 51 as

these procedures are not reported as

standalone codes. This means that you

cannot append the 59 modifier or the 51

modifier or the 50 modifier with the

add-on codes because they are not

reported as standalone codes. Now let's

look into the next guideline. Next it is

about the separate procedure. So this is

similar to what we followed in the

surgery section as well. But let's once

again review what the separate procedure

guideline is all about. When a procedure

or service that is designated as a

separate procedure is carried out

independently or considered to be

unrelated

or distinct from the procedure or

service provided at that time. It may be

reported by itself or in addition to the

other procedure or services by appending

a 59 to the specific separate procedure

code to indicate that the procedure is

not considered to be the component of

another procedure but is a distinct

independent procedure which means that

if you have a procedure if you have a

CPT code that has been designated as a

separate procedure and that is unrelated

and distinct from the other procedure

the major procedure it is not related to

that in that case we can code the code

we can code the CPT code which is

designated as a separate procedure by

appending 59 modifier to it. So in case

if the CPT code that has been designated

as a separate procedure is an part of

the major procedure or it is related to

the another CPT code or the procedure

then we cannot code that along with it.

Now let's move on to the next which is

about unlisted service or procedure

that also is same as the surgery

section. It says that if a service or

the procedure may be provided that is

not listed in addition in addition of

the CPT book you can report such

services using appropriate unlisted

procedure codes. All you have to do is

that you have to produce a separate

procedure special report for that. Sorry

you have to give a special report along

with it.

Imaging guideline. Imaging guidance.

This guidelines is same as the radiology

section and supplied materials. The

supplies and materials

over and above those usually included

with the procedures rendered are

reported separately using the CPT code

99070

or specific supply codes. Now let's move

on to the next guideline about the

foreign body or implant. So the

definition by definition an object

intentionally placed by a physician or

other qualified professional for any

purpose that may be either diagnostic or

therapeutic is considered to be as an

implant and if an object is

unintentionally placed

it is considered to be as a foreign

body. So if you guys if you if you have

observed any of those operative reports,

you might have seen that somewhere it is

documented that the surgeon counted the

surgical instruments or a scissors or

the screws whatever they have used. They

will make a count after the procedure.

That is to make sure that nothing is

left behind in a patient's body during

the surgery.

And if an implant that has been moved

from its original position or is

structurally broken and that no longer

serves its intended purpose or present

as hazard to the patient, it qualifies

for a foreign body for the coding

purpose.

So I guess now you all know what's the

difference between a foreign body and an

implant. With that let's move on

to the next section. So this is all

covered. You can see a lot of section

that has been included in the medicine

chapter. So as I said this is one of the

law which is one of the biggest chapter

in the CPT book and it includes a lots

of services which are not which are not

which are not mentioned in the surgery

section because they they are nonin

invasive procedure which is performed.

So let's have a look quick look into

what are those CPT codes for the

chapters which are included in the

medicine section. We have immune

globling serum or re combinant products

immunization administration for vaccines

or toxides vaccines toxoid psychiatry.

We have bio feedback. You can see the

dialysis gastroenterology ofology. We

have special auto rhino langio ling

lingolic

services.

We have cardiovascular services which

has been performed that is also included

in the muscular skill in in the medicine

chapter.

Next we have noninvasive vascular

diagnostic studies, pulmonary studies,

allergic and clinical iminology,

endocrinology, neurology and

neuromuscular procedures.

You also have medical gentics and

genentic counseling services, adaptive

behavior services, central nervous

system assessment or test, cognitive

mental status, speech testing, etc. We

have health behavior assessment and

intervention, behavioral management

services, hydration, therapeutic

prophylactic diagnostic injections and

infusions and chemotherapy and other

highly complex drugs or highly complex

biologic agent administration. We have

photodnamic therapy, special

dermatological procedures, physical

medicine and rehabilitation, medical

nutrition therapy, acupuncture,

osteopathic manipulative treatment,

chiropractic manipulative treatment,

education and training for patient

self-management, non-faceto-face,

non-fysician services, special services,

procedures and reports, qualifying

circumstances for anesthesia, moderate

consciousness, ation the other services

and procedure home health procedure

services medication therapy management

services yes that's a lot lot of topics

that has been discussed in the medicine

section and you also have a lot of

guidelines related to each of these

topics. So my tip for you all is to go

and ch your medicine section and that

will help you lot during exam.

So now that's now it's qu time and what

do you know about immunization? It's

time for me to just quickly check what

you know about immunization. So are you

ready?

Yes. So this is your first qu question

and you can put your answers in the

chat. Yes, I can see you all are in high

spirit rates. Oh, I can see the answers

coming up before I read the question. So

when coding vaccinations autoxide, how

many codes are required? So quickly you

can place your answers in the chat.

There you go. Answers are coming. And

okay, you can also mention the two codes

that are required. You can also go ahead

and mention.

Yes, as I said there are minimum two

codes that are required when coding the

vaccination autooxide and they are one

product code what is being inserted into

the body. Yes. And second is

administration code that is for a route

of administration of that product such