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Overview of the Category III CPT® Codes

Presenter Claire Stevenson, COC, CPC, CDEO, CIC, CPMA
Broadcast Date 1/31/2024
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
Overview of the Category III CPT® Codes Webinar

Learn more about this event

This presentation will cover a broad range of important topics related to coding for services that have a Category III code. Category III codes are new services that have yet to be statistically reviewed from a financial, documentation and clinical standard before proper reimbursement can be calculated and payor policies can be drafted for public review.

Category III codes are treated a little differently than normal CPT® codes as they are still experiencing “growing pains” in the coding world. But they do still need proper documentation, proper coding and proper medical necessity. During the period of review, coders must understand the importance of the process these codes undergo and act accordingly as it will impact reimbursement for these services after the review is completed.

Learning Objectives/Agenda

• Understand the basics of Category III codes
• Understand the sunset date
• Understand the process of transition from Category III code to CPT® code
• Understand the claim submission requirements for Category III codes
• Understand the reimbursement for Category III codes

Why is this topic important?

New codes are cycling into the code set routinely, sometimes twice a year and these new codes might be brand new services altogether that is under review for reimbursement, or may have been recently created new codes that are out of review and are now payable services. It is important to know the difference and how to handle the specifics of claims processing as well as documentation.

Who would benefit from this topic?

• Professional Fee for Service Coders
• Coding Managers
• Billers
• Practice Managers
• Auditors
• Revenue Cycle Managers

What’s the presenter's background/expertise on this topic?

Our committee has a broad range of experience in services related to inpatient services, outpatient services, surgical services and specialty medicine services. We worked with Category III codes in many instances and have seen firsthand the effects coding has upon proper reimbursement.

Claire Stevenson, COC, CPC, CDEO, CIC, CPMA

About The Author

Claire Stevenson, COC, CPC, CDEO, CIC, CPMA

Claire Stevenson, CPC, CIC, COC, CPMA, CDEO has experience across a wide range of specialties, with special interest in both inpatient and outpatient surgical coding. She began her career as a coder, progressing into auditing, education and management. 
She currently works for Sentara Healthcare as a Coding Quality Education Specialist for the Program Integrity Unit. 
Claire also contracts with AAPC as a Subject Matter Expert (SME) and is a member of their Coding Advisory Committee.

 

Linda Renner, CPC, CPCO, CPMA, CDEO, CRC, CPC-I, CEMC, CCC, CGSC has 25+ years of experience in the business side of medicine, starting as a medical assistant and progressing through varying roles from a coder to an auditor, educator, clinic and coding management. 
She currently works for Saint Luke’s Health System in Kansas City, Missouri as a Coding Analyst for the Population Health team where her focus is risk adjustment review, and provider education.
Linda also contracts with AAPC as virtual (VILT) instructor, a Subject Matter Expert (SME), and is part of their Coding Advisory Committee.  

 

 

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