Question
Where can I find specific definitions on the CPT codes?
Answer
I would recommend looking in two places. The first is a book that comes out of the AMA, the American Medical Association, because they actually own the CPT codes. This book describes every single CPT code and what is involved in it. If you cannot get your hands on this book, I would recommend that you go to your Medicare Administrative Contractor. Each one of the MACs will have local coverage determinations for OT, PT, and speech on their website, and within those there will be very specific guidelines, more often than not, on what is involved in a CPT code and what they look for in documentation from us. The one that I go to most regularly is National Government Services. I am not saying they are good, bad, or otherwise, but I happen to like how they lay out to their definitions and what they would want to see in the documentation to support that. If you use these documents, your payers clearly spell out what they want to see from your documentation. If you do not, they are probably not going to pay.
