Coding Guide – How Physician Services are Paid

Table of Contents

• CPT^®
• HCPCS
• Modifiers
• NCCI
• Multiple procedures
• Fee calculation
• Global surgical payment
• Diagnosis coding

A physician sees a patient in the office or treats a patient with a fracture in the emergency department and wants to get paid for this service. That shouldn’t be too much to ask, should it?

The coding and reimbursement system in the United States is anything but simple and easy. This billing guide explains how all of the parts come together that result in payment for that physician.

This is an essential resource for new physicians, non-physician practitioners, coders and billers and for managers who want to know just enough to manage. In addition to this billing guide, be sure to reference the helpful infographic and Betsy’s 15 minute video on the payment process.

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Revised 1/24/19