Obtaining The Code Sets

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	Obtaining The Code Sets

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New CPT Codes

Knowing where to obtain and verify codes for medical office claims billing may be a no-brainer to some. Others may not be quite sure how to find resources and points of contact to get the codes they need.

Here are some places to look New versions of CPT codes are usually released during the fall and changes go into effect the following January, on the first day of the new year. For more information contact the American Medical Association at 800-621-8335 or 515 North State Street, Chicago, Illinois 60610.

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Where Do You Get The Code Sets?

CPT® books provide all the procedural terminology and ICD-9-CM code books have the most up-to-date information on medical diagnosis coding. The medical coder must stay current on any new ICD-9 code changes that would impact code accuracy and claims submission.

The CPT codes are copyrighted by the AMA and should be obtained through that organization, however they also are available through several private sector vendors such as below.

List of CPT Codes (SAAGII Incorporated)

ICD-9-CM manuals may be ordered from the AMA by calling 800-621-8335, or from Channel Publishing at 800-248-2882. A CD-ROM of the complete listing can be ordered from the United States Government Printing Office at: US Government Printing Office, PO Box 371954, Pittsburgh, PA 15250-7594 or call the Ordering Office at 866-512-1800.

Note: All code sets are reviewed and subject to modification annually, so it is important to have the most current version of these codes for billing purposes.

Read: Process for Requesting New/Revised ICD-9-CM Procedure Codes

CD-ROM Version Of ICD-9-CM

HIPAA Books

HIPAA books help to develop an effective HIPAA compliance plan and DRG books are needed for Medicare's classification of inpatient hospital services based on principal diagnosis, secondary diagnosis, surgical procedures, age, and gender. The Government Printing Office (GPO) also offers a paper copy of the alphanumeric HCPCS and also contains the dental codes.

Note: GPO orders can be placed at 202-512-1800. HCPCS books contain the complete lists of HCPCS Level II codes with descriptions. They will guide the medical coder through current modifiers, code changes, additions and deletions.

Alphanumeric HCPCS

The alphanumeric HCPCS file is sold by the National Technical Information Service (NTIS) on tape, CD-ROM, or diskette. NTIS orders can be submitted by phone at: 703-487-4650

or by e-mail at: orders@ntis.fedworld.gov.

Medicare HCPCS

Healthcare Common Procedure Coding System (HCPCS) alphanumerical lists and updates.

Codes For Clinical Labs

AMA's CPT Editorial Panel establishes codes for new clinical diagnostic laboratory tests which then are used by Centers for Medicare and Medicaid Services (CMS).

Twenty codes for new clinical laboratory tests, established by the Current Procedural Technology (CPT) Editorial Panel, will become effective January 1, 2006.

Medicare ICD-9 Provider & Diagnostic Code Updates and Revisions to ICD-9-CM Procedure Codes (Addendum).

Dental Procedures and Nomenclature

Codes for Dental Procedures and Nomenclature is available from the American Dental Association at 800-947-4746. The most recent version of the Code has been effective since January 1, 2005 and may be found within the ADA publication titled CDT-2005.

Read: Code on Dental Procedures and Nomenclature

Temporary coding changes are noted in Program Memoranda (PM) to Medicare carriers and fiscal intermediaries. PM's can be accessed through of complications.