Overlooked CPT Codes By Physicians That Cost Them

Many physicians are facing many challenges in today’s healthcare economy. As a physician, CPT codes may be easily brushed aside among other significant tasks in your workday. Still, CPT codes are an unavoidable part of the job that could affect your bottom line. This is the reason why we have to look into what are CPT codes and why they are important.

How can we define CPT?

CPT codes are Current Procedural Terminology codes used in every area of healthcare. This streamlines the medical billing practices across the country, ensuring that inpatient and outpatient procedures get billed consistently across all hospitals and practices. Your practice can be radiology, cardiology, or any other subspecialty – CPT codes will remain to be used. It is required to indicate the service provided and receive reimbursement from payers.

Here are the three categories of CPT codes:

Category I codes

This describes the services and procedures

Category II codes

This tracks follow-up care and outcomes

Category III codes

This notes when a physician uses an emerging technology

You have to remember that the American Medical Association annually updates the complete list of CPT codes. That’s why it’s crucial to have billing experts who know the additional new codes every year, and old codes that get dropped or changed.

What happened when you fail to properly use CPT codes? It’s simple: Insurance companies can reject claims and deny reimbursement. Ultimately, the CPT codes you bill will determine how much you earn.

Family Practice Case Study

To receive the case study, with a list and explanation of these procedures, please provide us with your contact information and we will send it to you by email.

In the case study provided Synapse will focus on a family practice group, where most of the coding was billed with regular office visit codes when there were other codes available that could have been used in place of old codes. If Synapse did not inform the staff, the practice could have missed out on billing these procedures at a higher pay rate and underutilized the provider’s billing potential and collections. The case study will also provide a list of updated items from the 2018 CPT, which were gathered to compare the current codes to their predecessors. The results of the study are an eye-opener for medical providers.

CPT updates are done annually and periodically, and as necessary: providers are expected to keep up, be educated, train personnel, understand changes to the terminologies described by the CPT guide, and adopt its changes. Providers need to make sure to stay informed to ensure that they are getting optimum reimbursements. To receive the case study with a list and explanation of these procedures, please provide Synapse Revenue Cycle Management with your contact information and we will send it to you by email.


Our team always ready to help you

Synapse has the expertise to help our clients achieve their revenue goals. We take care of all your practice management needs so you can stop worrying about organization and profits and focus on your patients.

Please leave your contact information for a free consultation with one of our practice specialists or call us at (844) 384 7532.