Intro Revised18

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CPC Exam – Pages 14 to 18

IMPORTANT POINTS (Must Remember)

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1️⃣ CPT Code Categories (Very Important)

👉 3 Categories only

🔹 Category I

• 5-digit numeric codes
• Most commonly used in exam
• Divided into 6 sections:
  1. Evaluation & Management (E/M)
  2. Anesthesia
  3. Surgery
  4. Radiology
  5. Pathology & Laboratory
  6. Medicine
• Used for procedures/services performed by physicians

📌 Exam Tip:
If question asks “Which codes are used for reimbursement?” → Category I

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🔹 Category II

• Supplemental tracking codes
• Format: 4 digits + F (e.g., 0001F)
• Used for quality measures, NOT mandatory
• No RVUs, not used for payment

📌 Example: Performance measurement

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🔹 Category III

• Temporary codes
• Format: 4 digits + T
• Used for new / emerging technology
• May or may not lead to Category I later

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🧠 Memory Trick

👉 I = Insurance
👉 II = Improvement (Quality)
👉 III = Trial (New Tech)

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2️⃣ CPT Code Format Rules

• Codes are listed in numeric order
• Semicolon ( ; ) means:
  • Same prefix text applies
• Indented codes:
  • Must read with the parent code description

📌 Never code an indented code alone

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3️⃣ Parenthetical Notes (EXAM FAVORITE)

• Found below or beside CPT codes
• Give instructions, not codes
• Tell you:
  • “Do not report with…”
  • “Use additional code…”
  • “Instead, see…”

🚫 Never assign parenthetical notes as codes

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4️⃣ CPT Symbols (Must Know)

Symbol	Meaning
● (Bullet)	New code
▲ (Triangle)	Revised code
⚡ (Lightning)	FDA-approved vaccine
⦿	Add-on code
🚫	Exempt from modifier -51

📌 Add-on codes

• Never reported alone
• No modifier -51 needed

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5️⃣ Guidelines (Super Important)

• Found at beginning of sections
• Must be followed before coding
• Override individual code descriptions

📌 Exam Rule:
👉 Guidelines > Notes > Code Description

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6️⃣ Unlisted Procedures

• Used when no specific CPT code exists
• Require:
  • Full documentation
  • Comparison to similar procedure
• Often paid manually

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7️⃣ Key Exam Reminders

✔ Always read section guidelines first
✔ Do not code from index alone
✔ Parenthetical notes guide what NOT to do
✔ Category II & III → not primary payment codes

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🔑 LAST-MINUTE MEMORY LINE

Guidelines first, Category I pays, II tracks quality, III is temporary, notes are instructions—not codes.

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