Getting CPT Codes
- Has participated in the CPT coding process since 1999
- Understands how to navigate the CPT process
- Advises on whether to get CPT codes
- Assists in drafting CPT code applications and preparing clients for CPT meetings
- Understands how and when to get Category 1 and Category 3 CPT codes
- Attends all CPT meetings on behalf of clients
Getting HCPCS Codes
- Was a member of the CMS HCPCS coding team while at CMS
- Regularly assists clients in drafting applications for HCPCS codes
- Assists in drafting presentation to the HCPCS coding public meetings
- Assists in drafting comments to CMS preliminary determinations
- Assists in obtaining appropriate reimbursement for new HCPCS codes
Getting Clinical Lab Codes
- Assists in obtaining CPT codes for in vitro diagnostic tests
- Assists in obtaining Category 1 codes, Proprietary Lab Analysis (PLA) codes, and codes for Multianalyte algorthimic analysi (MAAA) tests
- Assists clients in preparing for the annual CMS lab clinical lab test payment meeting
- Attends the payment meeting and makes presentations on behalf of clients when appropriate
- Assists in drafting comment letters and meeting with CMS in response to preliminary payment determinations
Appropriately Interpreting and Using CPT and HCPCS Codes
- Advises clients on requirements for reporting existing CPT and HCPCS codes
- Advises clients on educating members and clients on coding issues
- Reviews reimbursement materials to assure accurate information on coding ir provided
- Assists in drafting letters to CPT and/or medical specialty society on appropriate use of codes
Challenges to Getting Codes
- Has extensive experience navigating the CPT and HCPCS coding process
- Understands how to gain support from other stakeholders for client coding applications
- Provides advice on when to revise or withdraw coding applications