For which of the following processes should a MAA verify a patient's CPT code?

Verifying a patient’s CPT code is especially crucial for obtaining prior authorization. Prior authorization is a process used by insurance companies to determine whether a specific service or procedure is medically necessary before they will cover the costs. Accurate CPT codes are essential in this context because they identify the specific services or procedures being requested for coverage.

By confirming the correct CPT code, the Medical Administrative Assistant ensures that the prior authorization request aligns with the services the provider plans to deliver. Insurers rely on these codes to assess the appropriateness of the service, which can significantly affect the approval process. If the provided code does not accurately reflect the procedure being requested, it could lead to delays, denials, or even unnecessary costs for both the patient and the healthcare provider.

Coordination of Benefits, determining eligibility of services, and receiving a referral might rely on different data points or documentation processes. While those processes are essential in medical office administration, they do not specifically require the verification of CPT codes to proceed effectively as obtaining prior authorization does.