CCSA INTRODUCTION

The Complete CPT® for South Africa consists of the American Medical Association’s Physicians’ Current Procedural Terminology (CPT®), which is a systematic listing and coding of procedures and services performed by medical practitioners.  Linked to these procedures and services is the Medicare Resource-based Relative Value Scale, which consist of relative value units for facilities and non-facilities, where appropriate.

Each procedure or service is identified with a five-digit code.  The use of CPT® codes simplifies the reporting of services.  With this coding and recording system, the procedure or service rendered by the medical practitioner is accurately defined.

Inclusion of a descriptor and its associated specific five-digit identifying code number in CPT® is generally based upon the procedure being consistent with contemporary medical practice and being performed by many medical practitioners in clinical practice in multiple locations.

The main body of the material is listed in the following six sections:

  •  Evaluation / Management99201-99499

  • Anaesthesia00100-01999

  • Surgery10040-69990

  • Radiology70010-79999

  • Pathology / Laboratory80048-89398

  • Medicine90281-99607

Within each section are subsections with anatomic, procedural, condition, or description subheadings.  The procedures and services with their identifying codes are presented in numeric order with one exception - the entire Evaluation and Management section (99201-99499) has been placed at the beginning of the listed procedures. These items are used by most medical practitioners in reporting a significant portion of their services. The Medicine (procedures) section follows on the section for Pathology and Laboratory. A sub-section Special Services and Reportsappears at the end of the Medicine section and contains, amongst others, information on After Hour Services and Travel Costs.

It should be noted that every effort should be made to code as accurately as possible even if third party funders do not grant benefits for all services rendered.  In these cases patients should be held responsible for payment for services where benefits were not granted by third party funders.  Please remember that third parties may elect not to directly remuneration the medical practitioner for the services rendered and make the payment for the service (even at the benefit amount) directly to the patient (their member).

 

 

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