Pots And Cpt Codes-insurance

[mkoven]

hi,

I'm trying to get insurance to cover my rehab, and they need cpt codes. I have one for syncope -780.2. Anyone know the one for POTS? I've googled to no avail.

thanks!

[delphicdragon]

I'm fairly certain there isn't one. For the insurance my doctor lists tachycardia and palpitations. (Can't remember the codes)

Sara

[Maxine]

I found this though the websites below: Still looking for CPT codes------edit pending--- CPT is 5 digits...

http://www.med.ufl.edu/complian/Q&A/cpt-codes.html

http://www.aetna.com/cpb/medical/data/200_299/0285.html

785.0 Tachycardia, unspecified [postural orthostatic tachycardia syndrome] But this is ICD-9 code

I took a medical coding program in 2003, but this was not listed in our books yet.

Maxine :0)

[ajw4790]

Hi,

I think you are looking for the ICD-9 code right? Not CPT code right? Because aren't most CPT codes codes for treatment, procedures, etc?

I don't think there is a specific one. I think it is more Tachycardia, Cardiovascular condition not otherwise specified, or syncope. I may look it up more later...

Good Luck!

[Maxine]

What is a CPT code?

CPT is an acronym for Current Procedural Terminology. CPT codes are published by the American Medical Association, and the fourth edition is the most current. The purpose of the coding system is to provide uniform language that accurately describes medical, surgical, and diagnostic services.

A CPT code is a five digit numeric code that is used to describe medical, surgical, radiology, laboratory, anesthesiology, and evaluation/management services of physicians, hospitals, and other health care providers. There are approximately 7,800 CPT codes ranging from 00100 through 99499. Two digit modifiers may be appended when appropriate to clarify or modify the description of the procedure.

It is published in two versions - the first is the most common, CPT Physician's Current Procedural Terminology. A second publication is also available - the CPT Physician's Current Procedural Terminology Specially Annotated for Hospitals. The Hospital version contains all the information in the original version with the addition of special Medicare guidelines and notations for identifying criteria applicable to outpatient hospital billing.

The rules for assigning the appropriate code are complex, and so we advise individuals who are determining the appropriate codes receive the proper training and credentials. This would include any office or clinic personnel who play a significant role in coding.

What is an ICD-9 Code?

ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) coding system is used to code signs, symptoms, injuries, diseases, and conditions.

The relationship between ICD-9 (diagnosis) and CPT (procedural) Codes

The critical relationship between an ICD-9 code and a CPT code is that the diagnosis supports the medical necessity of the procedure. Since both ICD-9 and CPT are numeric codes, health care consulting firms, the government, and insurers have all designed software that compares the codes for a logical relationship. For example, a bill for CPT 31256, nasal/sinus endoscopy would not be supported by ICD-9 826.0, closed fracture of a phalanges of the foot. Such a claim would be quickly identified and rejected.

The above is from one of the links posted---

ICD-9 code, 785.0 is used for POTS

Maxine :0)