Current Procedural Terminology (CPT)

A standardized medical code set maintained by the American Medical Association (AMA) used to report medical, surgical, and diagnostic procedures and services provided by healthcare providers.

 

CPT Cod

A five-digit numeric code used to describe medical, surgical, or diagnostic procedures and services rendered by healthcare providers.

 

Modifier

An additional two-digit code appended to a CPT code to provide additional information or specificity about the service or procedure performed.

 

Evaluation and Management (E/M) Codes

A subset of CPT codes used to report services provided by healthcare professionals for patient evaluation, management, and counseling.

 

Global Period

The period of time surrounding a surgical procedure during which preoperative, intraoperative, and postoperative services are included in the reimbursement for the procedure.

 

Bundled Code

A single CPT code that represents a group of related procedures or services that are typically performed together and reimbursed as a single entity.

 

Unbundling

The improper billing practice of separately reporting components of a bundled service using multiple CPT codes to increase reimbursement.

 

National Correct Coding Initiative (NCCI)

A set of coding policies developed by the Centers for Medicare & Medicaid Services (CMS) to promote correct coding methodologies and prevent improper coding practices.

 

Level of Service

The degree of complexity or intensity associated with a specific medical service or procedure, often determined by factors such as history, examination, and medical decision-making.

 

Crosswalk

A tool used to map or translate between different code sets or classification systems, allowing for the conversion of codes from one system to another for billing or reporting purposes.