CPT Certification

Earning a certification is one of the most beneficial things you can do when you seek to start or advance your career in medical billing and coding. Those who earn certifications are more likely to get a medical coding job over someone who has not earned a certification. The same is true for being offered a higher paying job. Employers seek to hire those who have shown their commitment to the field by earning a medical coding certification.

What is CPT?

Current Procedural Terminology, or CPT, is not a certification. CPT is a type of code that you will need to know in order to earn a certification in medical coding. It is one of the primary codes used throughout the medical field.

Coders use CPT to document medical, surgical and diagnostic procedures that are performed within a healthcare facility. CPT codes are used by healthcare providers, insurance companies and healthcare facilities.

The American Medical Association (AMA) created CPT in 1966 and still maintains it. They recognize that the healthcare system is constantly changing and in order to keep the codes relevant, AMA releases annual updates.

How is it Used?

When a doctor meets with a patient they write down notes about what was discussed and what procedures were performed during the appointment. The document then gets sent to medical billers and coders. The medical coders use CPT to standardize what was documented for that patient. By using CPT the coders create a record for that patient. The record is then turned into a bill and used by the healthcare provider to receive reimbursement for the appointment.

Understanding CPT is vital to becoming a medical biller and coder. Not only will employers not hire you without CPT knowledge, it is also necessary if you hope to pass a certification exam.

Understanding CPT Code

Now that you know what CPT codes are and how they are used, it is important that you understand how they are broken down.

CPT codes will always be five-digit numbers. These numbers correspond to particular procedures that are used in the documentation process.

These codes are divided into three categories:

  1. Category I- Is the most used category. It covers all of the codes used for procedures and services and includes six different subcategories:
  • Anesthesia
  • Surgery
  • Radiology
  • Pathology and Laboratory
  • Medicine
  • Evaluation and Management
  1. Category II- This category is used to track performance measurement. However, it is not required to create a correct code. It is most often used in addition to category I codes for evaluation and management. It cannot replace category I codes.
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  3. Category III- These are temporary codes used for new technologies, services and procedures. This category is rarely used and serves to collect data about the new methods that are utilized.

CPT is a complex coding system. Understanding it can feel overwhelming. Remember that many schools offer courses that teach students how to understand and apply medical codes. Taking these courses can prepare you to start you career in medical coding and billing, as well as prepare you to take a coding certification exam.

Who Certifies?

Once you feel secure in your medical coding knowledge, you may want to earn a certification. There are two nationally recognized agencies that offer medical coding certifications: the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).

The AAPC is considered the gold standard in medical coding certification. They offer the most certifications for coders:

  • Certified Professional Coder (CPC)
  • Certified Outpatient Coding (COC)
  • Certified Inpatient Coder (CIC)
  • Certified Rick Adjustment Coder (CRC)
  • Certified Professional Coder-Payer (CPC-P)
The AHMIA focuses on health care information management, as you may have gathered from their name, but also offers medical coding certifications:

  • Certified Coding Associate (CCA)
  • Certified Coding Specialist (CCS)
  • Certified Coding Specialist-Physician-based (CCS-P)

Both agencies test your ability to apply medical code sets, such as CPT. They also test your knowledge of evaluation and management principles, along with documentation and coding guidelines.

What to Remember

You may have noticed that medical billing and coding includes a lot of different acronyms. It is important that you know what all these acronyms stand for and how they apply to the industry.

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