What is a CPT code and Why is it Required?
March 31, 2023
If you've ever received medical treatment or services, you may have come across something called a CPT code. But what exactly is a CPT code, and why are they required?In this blog post, we'll explain what a CPT code is and how it's used, as well as why it's important for both healthcare providers and patients to understand and use CPT codes.
What is a CPT Code?
CPT stands for "Current Procedural Terminology," and CPT codes are a standardized system of codes that describe medical, surgical, and diagnostic procedures and services.CPT codes are used by healthcare providers to document the services they provide and by insurance companies to determine how much they will pay for those services. They are developed and maintained by the American Medical Association (AMA).There are thousands of CPT codes, each one corresponding to a specific procedure or service. For example, a CPT code might be used to describe a routine physical exam, a surgical procedure, or a diagnostic test.
Why are CPT Codes Required?
There are several reasons why CPT codes are required:
To accurately describe medical procedures and services: CPT codes provide a standardized way to describe medical procedures and services, which helps to ensure that everyone is using the same language when it comes to healthcare. This can be especially important when it comes to insurance billing, as it helps to ensure that everyone is on the same page about what services were provided and how much they should cost.
To facilitate insurance billing: CPT codes are used by insurance companies to determine how much they will pay for a given procedure or service. When a healthcare provider submits a claim to an insurance company, they must include the CPT codes for the procedures or services that were provided. The insurance company will then use these codes to determine what they will cover and how much they will pay.
To track healthcare trends: CPT codes are used to collect data about the types of procedures and services that are being provided in the healthcare system. This can help policymakers and researchers to track trends in healthcare and identify areas that may need improvement.
To support research and quality improvement: CPT codes can be used to track the outcomes of different medical procedures and services, which can help researchers and healthcare providers to identify best practices and improve the quality of care.
Which CPT Codes Does Nirvana Support?
Nirvana currently supports the following CPT codes:
90837: This code is used to bill individual therapy sessions between a psychotherapy provider and a client lasting 60 minutes (a minimum of 53 minutes). This is a commonly billed CPT code for patients receiving treatment for psychiatric disorders.
90834: This code is used to bill individual therapy sessions between a psychotherapy provider and a client lasting 45 minutes (a minimum of 38 minutes). This is a commonly billed CPT code for patients receiving treatment for psychiatric disorders. Some insurance companies consider 90834 to be the ‘standard’ psychotherapy session.
...Stay tuned for more Nirvana supported CPT codes coming soon!