Coding in dermatologic surgery

Knowledge about surgical current procedural terminology (CPT) coding is essential to every surgeon, because accurate coding allows for proper reimbursement, decreases the possibility of being audited, and decreases the likelihood of inadvertently misrepresenting a claim. It is also important to have proper documentation to substantiate submitted claims. Accurate coding and documentation promote the timely processing of claims and decrease the likelihood of having to appeal denied claims.

CPT codes

The CPT codes are developed by the American Medical Association (AMA) and are used to describe the type of services provided to a patient. Each code consists of a combination of numbers that defines a specific medical, surgical, or diagnostic service. These codes are universal and allow for accurate communication of information about medical services and procedures among medical providers, coders, accreditation organizations, and payers. The reimbursement to providers for services received by patients is determined by the CPT code(s) used.

The CPT system is a registered trademark of the AMA, which is responsible for assigning codes for newly developed services, revising current codes, and eliminating outdated codes. Codes are updated annually. Because the AMA has a copyright on the CPT codes, free use and distribution of these codes is not permitted. The AMA charges a license fee to associate relative value units (RVUs) with CPT codes. Software and several books and manuals are also available to aid those who use CPT codes. The AMA receives approximately $70 million annually from these licensing fees and the sale of reference materials.