Current Procedural Terminology Codes

Besides the basic demographic information that you will be entering into the patient's records so that you can successfully file the claim, your doctor is also required to provide specific coding that communicates to the insurance payor what services were rendered that day for the patient. These are known as Current Procedural Terminology codes or CPT codes and they are very, very important to have with every claim you file. If you don't, the claim will be denied. Again, it basically communicates what procedures, what special testing, what medical procedures might have been performed that day for the patient. Now, we are going to go over this in much more detail, in course number three and in program number two, but what I want to touch base on right now and to have you familiarize yourself with, is that there are 16 essential codes that are broken down into three sections.

The first one is our 92 codes. These are four Comprehensive and Intermediate Ophthalmic visit codes. So, it would be Intermediate, our 92002, which is for a new patient and our Intermediate 92012 for an established patient.

Then we have our comprehensive exam which is 92004 for new patients and our 92014 for an established patient. Note that there are specific codes for a new patient versus an established. And that’s very, very important that we get that accurate.

Alright, so besides are four Comprehensive and Intermediate Ophthalmic codes, we have 10 evaluation codes or EM codes and these are our 99 codes and they are broken down into four Comprehensive office visit codes, such as 99204 for New Patient Comprehensive Moderate Complexity as well as we have six problem-focused exam codes which are our 99202 New Patient Expanded Problem-focused. Just a couple of examples there for you to start familiarizing yourself with. Again, we'll go over more depth later on, but I want to introduce them to you.