Urology Coding Alert

Check intro for ‘other qualified health care professional’ clarification.

If your shiny new CPT® 2014 manual has arrived, the time has come to start adding your own notes to it. The AMA has updated its 2014 (and 2013) Errata and Technical Corrections document with some changes you need to know. One clarification sets the record straight about who actually qualifies as a “qualified health care professional.”

Tip: Some updates are classified as errata (E) and others as technical corrections (T). An errata shows information that was approved by the CPT® Editorial Panel but inadvertently left out of the current CPT® book. Technical corrections clarify the Editorial Panel’s intent for the current code structure.

Know Who Counts as ‘Qualified Health Care Professional”

CPT® 2013 introduced the use of “qualified health care professional” throughout the book when codes distinguish who is able to provide the service. The introduction to CPT® 2014 now includes an important clarification regarding this terminology.

Errata posted to the AMA website on Nov. 11, 2013, states, “Throughout the CPT® code set the use of terms such as ‘physician,’ ‘qualified health care professional,’ or ‘individual’ is not intended to indicate that other entities may not report the service. In selected instances, specific instructions may define a service as limited to professionals or limited to other entities (e.g., hospital or home health agency). Revise the instructions for use of the CPT® codebook guidelines to include missing content “define a service as limited to professionals or limited to other entities (e.g., hospital or home health agency).”

Bottom line: If you code for services rendered in a facility setting, you can still report codes that include “qualified health care professional” in the descriptor, when appropriate.

Resource: The complete lists of revisions are available on the AMA’s Errata and Technical Corrections page at www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt/errata.page.

The documents on this page will help you keep tabs on changes to CPT® codes throughout the year.