Soft-Coded CPTs

Soft-coded outpatient procedures are CPTs assigned by coding professionals after services are rendered, and are not stored in the chargemaster files. During bill generation, the CPT codes are tied to revenue code charges reflecting the location of the procedure (operating room, cardiac cath lab, etc.)

Managed care agreements and government fee schedules often contain negotiated rates for these procedures.
Turquoise reviews customer claims data to identify the CPTs and revenue codes for these soft-coded procedures and adds them as services to be priced in the MRF.

Since soft-coded CPTs are not stored in the CDM, within an MRF, they appear as lines with null values in the standard_charge | gross column. If you're looking to isolate your soft-coded CPTs or confirm the presence of soft-coded CPTs within an MRF, you can start by filtering out standard charges and reviewing any reported CPTs that remain.