Current Procedural Terminology, more commonly known as CPT, are a set of medical codes used by health professionals, physicians, non-physician practitioners, hospitals, outpatient facilities, and laboratories to describe the procedures and services they provide.
In simple words, CPT codes are used to report procedures and services to Govt. and private payers for reimbursement of rendered healthcare services.
AMA (American Medical Association) has organized CPT codes logically, beginning with classifying them into three types.
Category I —the largest body of codes consisting of those commonly used by providers to report their services and procedures
Category II —supplemental tracking codes used for performance management
Category III —temporary codes used to report emerging and experimental services and procedures
CPT Category I codes:
Evaluation & Management Services (99202 – 99499)
Anesthesia Services (01000 – 01999)
Surgery (10021 – 69990) – further broken into body area or system within this code range
Radiology Services (70010 – 79999)
Pathology and Laboratory Services (80047 – 89398)
Medical Services and Procedures (90281 – 99607)
CPT Category II Codes:
Composite Measures (0001F – 0015F)
Patient Management (0500F – 0584F)
Patient History (1000F – 1505F)
Physical Examination (2000F – 2060F)
Diagnostic/Screening Processes or Results (3006F – 3776F)
Therapeutic, Preventive, or Other Interventions (4000F – 4563F)
Follow-up or Other Outcomes (5005F – 5250F)
Patient Safety (6005F – 6150F)
Structural Measures (7010F – 7025F)
Non-measure Code Listing (9001F – 9007F)
CPT Category III Codes:
These are temporary codes that represent new technologies, services, and procedures. Temporary codes describing new services and procedures can remain in Category III for up to five years.
Other Code Sets:
CPT is one of four primary code sets. The other code sets are……
HCPCS Level II —used to report procedures, services, supplies, drugs, and equipment
ICD-10-PCS —used to report inpatient procedures (hospitals)
ICD-10-CM —used to report diagnoses for patients of inpatient or outpatient providers
The Centers of Medicare and Medicaid Services (CMS) wanted a classification system for medical supplies, equipment, medications, and services not included in CPT— so the AMA worked with CMS to develop a new set of codes called HCPCS Level II.
HCPCS Level II codes were originally used for Medicare patients, but other payers found them useful and began to require providers to use them.
What is CPT?
Current Procedural Terminology, more commonly known as CPT, are a set of medical codes used by health professionals, physicians, non-physician practitioners, hospitals, outpatient facilities, and laboratories to describe the procedures and services they provide.
In simple words, CPT codes are used to report procedures and services to Govt. and private payers for reimbursement of rendered healthcare services.
What are the categories of CPT codes?
AMA has organized CPT codes logically, beginning with classifying them into three types.
Category I —the largest body of codes consisting of those commonly used by providers to report their services and procedures
Category II —supplemental tracking codes used for performance management
Category III —temporary codes used to report emerging and experimental services and procedures.
What are HCPCS Level II Codes?
The Centers of Medicare and Medicaid Services (CMS) wanted a classification system for medical supplies, equipment, medications, and services not included in CPT— so the AMA worked with CMS to develop a new set of codes called HCPCS Level II.
HCPCS Level II codes were originally used for Medicare patients, but other payers found them useful and began to require providers to use them.
Learn more about….
Updated List of CPT and HCPCS Modifiers 2021 & 2022
Complete List of Place Of Service Codes (POS) for Professional Claims
