Medical coding is a major factor in obtaining insurance reimbursement as well as maintaining patient records. Coding claims accurately lets the insurance payer know the illness or injury of the patient and the method of treatment.
CPT codes are developed by the American Medical Association to identify codes most often used by physicians rendering services in the medical office.
HCPCS codes are developed by CMS (Centers for Medicare and Medicaid Services) to identify codes most often used for hospital services, supplies, and drugs.
The most frequently used codes are medical Evaluation and Management (E/M) codes.
- 99201-05: New Patient Office Visit
- 99211-15: Established Patient Office Visit
- 99221-23: Initial Hospital Care for New or Established Patient
- 99231-23: Subsequent Hospital Care
- 99281-85: Emergency Department Visits
- 99241-45: Office Consultations
In addition to accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-9 or diagnosis codes.