CPT Manual Bubbling and Highlighting Technique Explained – Video

The second part of the question was about our BHAT ™ method. That is a proprietary teaching method in term. It’s been trademarked of mine and CCOs and its licensees. It’s a very integral part of our method of teaching especially for the CPT Manual. Alicia said she uses it more for the ICD-10 now, so it will be interesting to see how it morphs into that new manual. And it really helps you understand how to really compare the neighboring codes to each other.

YouTube video

Let me show you an example here. This is just a page from my CPT manual, the very beginning of the surgery section. This one is a little less scary when you first look at it. But all I do, all I teach is that you will bubble what I call the parent code, so you see fine needle aspiration here, 10021. It’s capitalized, and then below it, indented, in lower case “with imaging guidance.” Then, there are some parenthetical notes below it and it moves on to the next section.

So this is a group, so I just circle, put a bubble around it. Then, what I do is I highlight everything and I pick one color. I always use pale yellow, every year I’ve been doing it since 1999. Then I save other colors for other things that I want to bring to my attention. But if I see pale yellow, I know that this is the portion of the code that comes after the semicolon, because when you’re flipping really quick on a stressful board exam or even in real world coding, sometimes it’s hard to see that little semicolon.

What it means now is 10022 with imaging guidance, this yellow part replaces the yellow part above. So, if I was to type this out fully, 10022, it would be “fine needle aspiration with imaging guidance.” And now this bubble gives you a nice little place to write a keynote, something, like, what is this bubble about? It’s about FNA. Then, I’ll underline the key words that make the two codes, or however many notes, within the bubble, stand out. It’s a timesaver especially on the board exam.

CPT Manual BHAT® Technique Explained – Video

Introduction and Removal is the next category here. We’ve got what I call a standalone code (it’s not what I call, it’s what CPT calls it) 10030: image-guided fluid collection. There are no indented codes underneath, that’s why it’s not in a bubble. It’s the same for 10040, it’s a standalone code.

Then we’ve got three bubbles, the 10060 bubble, 80 bubble, and 120 bubble. You can see how I circled the groups and have the indented codes bubbled in with the parent code. Then, what you do, now you have these bubbles, they’re all under the same category – Introduction and Removal – so you know they’re related.

Now, we look at what’s the difference between the bubbles? Well, this one is for an abscess, this one if for a pilonidal cyst, and this is related to a foreign body. Real quick, those buzzwords jump out at you and you can quickly ascertain what the difference is. That’s the example I always use.

I want to show you another page from my cardiology section that gets a little bit more complicated.

By the way, if you are a Blitz customer or a full course customer of ours, you get a video of every single page of my CPT manual, so you can copy all my notes, all my bubbles. That alone is probably worth the price of admission. The Blitz videos are $197, and we just started doing this two years ago. We can’t make a photocopy of my manual and give it to you, although people would love that. I get requests all the time from people to buy my last year’s manual that’s bubbled and highlighted, but now you can do it. With the video, it’s not me talking; it’s literally a video of just the book and it scrolls and you can hit pause, copy the notes, un-pause. It’s really a great tool.

What I did is I made a note for pacemakers. This happens to be the page about pacemakers. What are the key things about pacemakers that I want to abstract for, or do I need to pull out of the report? I need to know: 1) Is it temporary or permanent, 2) The method of placement, 3) The type of system (single or dual). Then, I start doing some bubbling here, so I bubble the indented codes in with the parent. I give it a little short note: epi for epicardial because that’s one of the differentiators; epicardial versus transvenous.

Then, the 33206 is the bubble for transvenous permanent. Then, I make little notes. This one was just in the atrium, this one is just in the ventricle, and this was in both. I reminded myself “Oh, that’s a single chamber, single chamber, dual chamber.” So, depending on the language that I see in the report, it’s just an aid to help me get to the right code.

What I like to do with my parenthetical notes is when it says something shouldn’t be reported with these codes or is allowed to be reported, I make a little note, “Well, what is that code?” so I don’t have to go look it up. “Oh, these are the removal codes.” “Oh, this one is the insertion of electrode codes,” so on and so forth

That’s the BHAT® technique, and you can see how it could be very helpful. Now, mind you, I used to be a neat-freak, type A; I wanted everything to be perfectly written and I’ve had people use rulers. What I realized when it looks too perfect, it doesn’t stand out when you’re looking at it. I purposely will write things in an angle because visually or mentally it does something to make it jump out at me and make me really stop and think about it. And a lot of these notes are not from my head or any special place, they’re literally from the guidelines that are normally a few pages ahead, or some sort of acronym or something like that. But it’s where we go to look at the codes, so it makes more sense to put them right there. Taking notes in a notebook that you can’t bring in on the board exam and you’re unlikely to go reference during real world coding aren’t very helpful. But putting it right here where the codes live is very helpful.

So, this is the BHAT® technique, so hopefully that will get you all excited about getting your highlighters out again. And watch your kids, they want to help you and then you get your book all colored.

 Learn More Details About CPT Manual BHAT®

CPT Stents and Cardiac Cath Coding Tips- BHAT® Example

AAPC – What is CPT®?

cpt manual bubble and highlighting


6 thoughts on “CPT Manual Bubbling and Highlighting Technique Explained – Video”

  1. Can I just purchase the BHAT system? Is it just for members? Is it a monthly cost? The membership says access to BHAT. What does that mean?

  2. Im working through anoth school but I am so interested in CPT HCPCS bubble notation video for 2023 Is this available? I am a student and frustrated

    • The BHAT® Method uses documents (not videos) now due to AMA copyright claims. You can get the latest 2023 version by joining the CCO Club at https://www.cco.us/club/. Please note we’re still working through several chapters of the CPT manual. HCPCS is not offered in the BHAT® Method.


Leave a Comment