Unlock the full potential of your medical coding capabilities with the CPT® Advanced Coding Pack from the American Medical Association (AMA). Designed for professional medical coders, auditors, and billers like you, this comprehensive suite of resources provides everything you need to navigate the complexities of the CPT code set with confidence and precision.
Advanced Coding Pack includes:
CPT Assistant - Newsletter with official education and guidance
CPT Knowledge Base - Commonly asked coding questions answered by the experts
CPT Vignettes - Comprehensive clinical examples.
Add to your Find-A-Code subscription for $300 / person
Pt = Point in time: To identify measures at a point in time. This is a synonym for “spot” or “random” as applied to urine measurements.
system
Emergency department
scale
Doc = Document: A document that could be in many formats (XML, narrative, etc.)
method
{Role}
Additional Names
short name
ED Prog note
Basic Attributes
class
DOC.ONTOLOGY
type
2 Clinical
order vs. observation
Both
Ask At Order Entry
Ask at Order Entry (AOE) observations for a clinical observation or laboratory test. A LOINC term may represent a single AOE observation or a panel containing several AOE observations.
LOINC codes that represent optional associated observation(s) for a clinical observation or laboratory test. A LOINC term may represent a single associated observation or panel containing several associated observations.
Based on Clinical LOINC Committee approval on 8/16/2011, the Component was changed from Subsequent evaluation note to Progress note. The term "Subsequent evaluation" seems to be used infrequently and is more commonly referred to as a Progress note. Also changed class from ATTACH.CLINRPT to DOC.CLINRPT since this term is conformant to the Document Ontology axis values and therefore being placed in this class.; Based on Clinical LOINC Committee decision during the September 2014 meeting, {Provider} was changed to {Author Type} to emphasize a greater breadth of potential document authors. At the September 2015 Clinical LOINC Committee meeting, the Committee decided to change {Author Type} to {Role} to align with the 'Role' axis name in the LOINC Document Ontology.
Related Names
DOC.ONT Document ED Encounter Evaluation and management Evaluation and management note Finding Findings
notes Point in time Prog note Random subsequent evaluation subsequent visit evaluation Visit note