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All providers of professional services and procedures are required to submit the bills for these services to the insurance companies using CPT® codes. CPT® codes describe the procedure or service that was performed, and the insurance company processes claims for reimbursement based on the CPT® code. It is the responsibility of the provider to submit accurate CPT® codes on the claim. In not doing so, a provider can be accused of fraud or abuse. Each year the CPT® manual is updated to remove services or procedures no longer performed, and to add or change services and procedures that are current treatment. Very often it is because new and better methods of treatment have emerged and are recognized as being affective. These changes are implemented for dates of service beginning on January 1st each year. It is the responsibility of the provider and their staff to understand and apply these changes on claims submitted to insurance companies to be compliant and avoid delays in reimbursement
The American Medical Association (AMA) Current Procedural Terminology (CPT®) is updated every year that becomes effective on January 1st. This manual is used by all professional providers to report services and procedures for reimbursement to insurance carriers. It is necessary for all providers to use the current CPT® based on the date of service. Failure to use the appropriate codes will result in claim denials and a delay in reimbursement
Senior Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served on several other boards for the AAPC. She is also the founder of her local chapter of the AAPC. Her experience is primarily in the specialties of Orthopedics, Rheumatology, and Hematology/Oncology. She has been a speaker for many conferences, including the AAPC National Conferences and Workshops, Community Colleges, audio conferences, and Local Chapters. Lynn became a CPC in 1993, and a Certified Instructor in 2002, and a Certified Orthopedic Surgery Coder in 2009.