5 Ways to Find the Most Appropriate CPT Code

5 Different Ways to Find the Most Appropriate CPT Code, Based on What You Know

Have you ever found yourself wondering how to get started finding the correct CPT Code?  Often times finding the most appropriate CPT code takes a bit of detective work.  The approach you take depends on the information you know or have.

Sometimes you have an exact code but are not sure that is the most appropriate for the situation.  Other times you may have the name of the procedure or an op note.  You may find yourself knowing the section of the CPT code but need to browse the codes to find the most appropriate.

Below I cover 5 common scenarios and detail the approach you should take to find the most appropriate CPT code for the situation.  I provide two options to find the code; 1.) the online coding tool CodingToday.com or 2.) Using the CPT Book.

There are many advantages to using an electronic coding tool such as CodingToday.com.  Not only will an electronic coding tool save you significant time but it will also provide you with additional options, based on past search algorithms, that you might not think to search if using a CPT book.

 

Number 1: 

I know the code number, but want to be sure it is the most accurate code for the procedure performed.

 

Using CodingToday.com

  1. Open CodingToday.com
  2. Click on “CPT Tab

 

  1. Enter “#” followed by 1st 3 digits of code followed by two underscores – a total of 5 characters and click go. Example: Target code is 4950549505 – Repair initial inguinal hernia, age 5 years or older; reducibleYou would enter #495__ (hash tag, “495”, two underscores)and there you have all the codes….
    If you think there could be more related codes, broaden search by dropping one digit #49___ (hash tag, “49”, three underscores)

Using a CPT Book

Look up the code and flip back and forth through the pages until you find the most appropriate code.

 


Number 2

I have the op note but I do not have the procedure name or number. I know the general code category but not the code number.

Using CodingToday.com

  1. Open “CodingToday.com
  2. Click on “CPT” in column on the left
  3. Select the correct category – Example, Click: “Surgery”
  4. Select organ system –Example, Click:Musculoskeletal System
  5. Select body part – Example, Click:Shoulder
  6. Select action – Example, Click: “Repair, Revision, and/or Reconstruction (23395-23491)”
  7. Review the list of codes….

Using a CPT Book

  1. Look at the table of contents under “Surgery”
  2. Find “Musculoskeletal System
  3. Go to the page listed for musculoskeletal system
  4. Start flipping through the pages, one by one, until you see the “Shoulder” section
  5. Continue flipping through the pages until you see the “Repair, Revision, and/or Reconstruction (23395-23491)”

Number 3

I know the name the procedure but do not know the code number

  1. Open “CodingToday.com”
  2. Click on “CPT” in column on the left
  3. Enter procedure performed and click go – Example: “tonsillectomy”
  4. Review the list of codes….

    Using a CPT Book

    1. Go to the index and find “Tonsillectomy”
    2. Review the codes
    3. Repeat as necessary to locate all the codes and review
    4. Return to the index and find additional terms that may apply (ie – tonsils, adenoidectomy, etc)  to make sure you have found all the codes
    5. Review the codes
    6. Repeat as necessary to locate all the codes and review

 


 

Number 4:

I know the Number for the general code category, but did not know the exact code

For example: I know it’s a urological endoscopy code located in the 52000                 code set

  1. Open “CodingToday.com”
  2. Click on “CPT”

  1. Enter “#” followed by 1st 2 digits of the code series, followed by three underscores – a total of 5 characters, and click go. Example: #52___ (hash tag, “52”, three underscores)
  2. Review the list of codes….

Using a CPT Book

  1. Flip to the Code 52000
  2. Flip through the pages to review the codes in the 52000 series

 


Number 5:

I have searched by name, no results

Using all possible similar names

Example: “Kidney Stones

Try searching: “calculi”, “calculus”, “urinary calculus”, “renal calculus”, “nephrolith”, “concretion”,etc 

Hint: try googling “synonyms Kidney Stones” if you need some words to search