Current Procedural Terminology (abbreviated as CPT) codes are the U.S. standard for how medical professionals document and report medical, surgical, radiology, laboratory, anesthesiology, and evaluation and management (E/M) services.
The CPT codes which describe physician-patient encounters are often referred to as E/M (evaluation and management) codes. All healthcare providers, payers, and facilities in the U.S. use CPT codes.
Basically, CPT codes are 5-character coding system used to facilitate billing, i.e. to help insurers determine the amount of reimbursement that a practitioner will receive for services provided.
CPT codes are used in conjunction with ICD-9 or ICD-10 codes during the electronic medical billing process.
CPT codes were first introduced and published in 1966 by the American Medical Association (AMA) that holds the copyrights and rights to develop and maintain these codes and update them annually.
Currently, thousands of CPT codes are in use, which makes the rules for assigning appropriate codes complex. Although CPT codes are standardized, too many physicians don't understand the rules, so they are not properly coding for their services or various providers are reimbursed differently for same services.
American Medical Association (AMA) developed CPT QuickRef app to make things a little bit easier and help healthcare providers determine the appropriate CPT Evaluation and Management (E/M) codes to use for billing for their services.
CPT QuickRef app comes in a bundle with CPT codebook that contains QR code. Users need to scan this code in order to access premium content, which is more than 90% of the app. The rest is available for free, so the users can first try the app to see how it works.
The interface of CPT QuickRef app is quite simple and easy to use. It lists several categories on the main screen (Dashboard), including CPT Codes that enables users to quickly find the codes, CPT Assistant that provides articles and tips, Favorites category with saved codes, Settings, Premium, and Legal.
There's also Search field at the top of the screen that enables quick lookup thanks to the autocomplete feature.
The main section of this app is certainly CPT Codes which contains Category I codes for different medical services, including Evaluation and Management, Anesthesia, Surgery, Radiology, and more.
There are also Category II and III codes, which include alphanumeric tracking codes used for execution measurement, and provisional codes for new and developing technology, procedures, and services.
In the free version of CPT QuickRef app, only Evaluation and Management (E/M) codes are available. They include codes for office or other outpatient services, hospital inpatient services, emergency department services, and more.
If you try to open other sections, the pop-up notification would inform you that the premium purchase is required.
Navigation through the app is simple. There's no Back button, but there's an arrow at the top that shows your current position in the app and opens a drop-down menu with 'breadcrumbs' allowing you to easily navigate to previous sections or return to dashboard.
Tapping on particular services will open a new page with services sub-sections that contain the appropriate available codes.
For example, if you open Nursing Facility Services, you'd see four further categories, including initial care, subsequent care, discharge services, and other services.
Keep in mind, however, that the app doesn't work offline. If you want to view codes you need an Internet access.
Each of the categories contains appropriate codes that can be viewed in the list, or by using E/M code wizard. The list, of course, contains all appropriate available codes with a brief description and a 'heart' icon enabling users to place them into Favorites category.
Upon opening the code, the app provides further explanation of the code with the table containing all RVUs (work, facility, malpractice, etc.) with the total cost for a particular service.
Users can check clinical examples for a particular code (not available for all codes), or guidelines (AMA, CMS 1995, or CMS 1997).
There's also a shortcut to CPT Assistant, however, it's only available after premium purchase, same as 2-digit modifiers option that describes service or procedure further.
The users can also use E/M wizard based on the guidelines (users can choose a particular one), which enables providers to enter patient's history, including chief complaint, history of present illness, review of systems, physical exam, number of diagnoses, diagnostic procedures needed, and so on.
Based on the data provided, the app suggests the most appropriate code that meets the criteria of the guideline chosen.
For some services, a wizard is provided in a more concise manner, enabling users to pick pre-defined entries in History, Exam, and Medical Decision Making categories, and provide them with the appropriate code.
All guidelines the coding systems are based on can be viewed inside the app, however, only E/M services Guidelines are adapted to the app's design. AMA and CMS guidelines are basically converted from PDF documents and need to be zoomed in for a better view.
Providers can find more information about the coding system, services, procedures and guidelines in CPT Assistant section, which provides useful articles and tips, but only after premium purchase.
The premium purchase also unlocks other useful features, such as Medicare Physician Fee Schedule calculator that can be set to the specific geographic region, more than 4,000 clinical examples, 200+ full-color procedural illustrations, and more.
Overall, CPT QuickRef app is a comprehensive reference tool for all healthcare providers who have trouble remembering appropriate codes, helping them ensure the billing for their services is accurate. The free version is quite limited, but premium purchase unlocks plenty of features that any physician would find useful in their practice.
Benefit: Any health care provider requiring help with CPT E/M codes and billing will benefit from this app