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Classification: Category 1

The document presents five case studies related to medical coding classifications. Case studies are categorized into three CPT code categories: Category 1 for established services, Category 2 for performance measurement, and Category 3 for emerging technologies. Each case study includes a justification for its classification based on the nature of the medical service or procedure.

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16 views2 pages

Classification: Category 1

The document presents five case studies related to medical coding classifications. Case studies are categorized into three CPT code categories: Category 1 for established services, Category 2 for performance measurement, and Category 3 for emerging technologies. Each case study includes a justification for its classification based on the nature of the medical service or procedure.

Uploaded by

mychellame2024
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Medical coding Assignment no – 3

Name – S.P.SWETHA

Case Study 1:
A 45-year-old patient visits a primary care physician for a
routine check-up, including a physical exam and blood pressure
monitoring.
Classification: Category 1
Justification: The service provided (routine check-up with blood
pressure monitoring) is a common, well-defined, and established
medical service, it falls under Category 1 CPT codes.

Case Study 2:
A hospital implements a new artificial intelligence (AI)-based
diagnostic tool for early cancer detection. The technology is still
under study and has not yet received full clinical adoption.
Classification: Category 3
Justification: Category 3 CPT codes are temporary codes used
for new, emerging technologies, procedures, and services that
are still in the research phase. Since the Al-based diagnostic tool
is emerging technologies it falls under Category 3 CPT codes.

Case Study 3:
A cardiologist documents a patient’s smoking status as part of a
quality improvement initiative, using a specific CPT code for
reporting purposes.
Classification: Category 2
Justification: Category 2 CPT codes are used for performance
measurement and quality improvement, rather than direct billing
for medical services. Documenting a patient’s smoking status as
part of a quality improvement initiative aligns with Category 2,
as it tracks clinical performance and patient outcomes.
Case Study 4:
A surgeon performs a laparoscopic appendectomy, which is a
well-established and commonly performed procedure.
Classification: Category 1
Justification: A laparoscopic appendectomy is a common
surgical procedure used to remove the appendix and it falls
under Category 1 CPT codes for established surgical procedures.

Case Study 5:
A new robotic-assisted orthopedic surgery technique is being
tested and documented under a temporary code for evaluation
before becoming a standard procedure.
Classification: Category 3
Justification: The robotic-assisted orthopaedic surgery technique
is newly emerging procedure so it falls under Category 3 CPT
codes.

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