CPT® 2012: CPT® Defines 'Other Qualified Healthcare Professional'

Why This Topic Matters

The topic matters because terminology changes and Medicare bundling rules can affect whether services are reported in a particular way and how claims are processed. Practices need to know which services are implicated and whether payer or facility policies alter the outcome.

Article Sections

1. Don't Miss Errata Clarifications

   This section discusses the CPT 2012 errata language and the broader explanation of the professional-service terminology. It also distinguishes the newly defined category from clinical staff.

2. Beware What the Definition Doesn't Include

   This section addresses the practical impact of the terminology update on nursing staff and related services. It also references how payer and state or local policies may affect reporting in different settings.

3. Medicare's 'Three-Day Payment Window' -- Do You Know What It Means?

   This section summarizes a Medicare payment-policy change affecting services furnished before a hospital admission. It also mentions associated reporting considerations in hospital-owned or operated practices.