Chances are, when you’re at the doctor’s office you aren’t thinking about CPT Codes. In fact most of us don’t even know what a CPT code is. Until recently, patients didn’t really have any involvement with these codes unless they contacted their insurance company or doctor’s office.
It stands for Current Procedural Terminology and every time you receive a medical service such as a flu shot, physical exam, stitches or more, your physician assigns a corresponding five-digit CPT code. Even so much as a brief five-minute telephone consultation with your doctor has a corresponding CPT code.
These codes are developed and maintained by the American Medical Association (AMA) and are used by insurers to determine the amount that a practitioner should be reimbursed by the insurance company. As the practice of health care undergoes reform, the AMA develops new codes for new services and current or old codes may be revised or discarded if unused. There are already thousands of CPT codes in use and these are updated yearly. Although everyone in the industry uses the same codes to ensure uniformity, it does not necessarily mean that each practitioner receives equal reimbursement for the same procedure.
As patients, we can learn a thing or two from CPT codes. When you receive a medical bill, a CPT code can prove handy in deciphering health costs. They reveal information about our medical issues, how they are being treated and how they determine medical billing. Your doctor’s office should be able to discuss any questions regarding CPT codes with you.