Current Procedural Terminology

The Current Procedural Terminology (CPT) code set is maintained by the American Medical Association through the CPT Editorial Panel.[1] The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.

New editions are released each October.[2] The current version is the CPT 2011. It is available in both a standard edition and a professional edition.[3][4]

CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim.

CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS) [5] as Level 1 of the Health Care Procedure Coding System.

Contents

Types of codes

There are three types of CPT codes: Category I, Category II, and Category III.

Category I

Category I CPT Code(s). There are six main sections:[6]

Codes for Evaluation and Management: 99201-99499

  • (99201 - 99215) office/other outpatient services
  • (99217 - 99220) hospital observation services
  • (99221 - 99239) hospital inpatient services
  • (99241 - 99255) consultations
  • (99281 - 99288) emergency dept services
  • (99291 - 99292) critical care services
  • (99304 - 99318) nursing facility services
  • (99324 - 99337) domiciliary, rest home (boarding home) or custodial care services
  • (99339 - 99340) domiciliary, rest home (assisted living facility), or home care plan oversight services
  • (99341 - 99350) home services
  • (99354 - 99360) prolonged services
  • (99363 - 99368) case management services
  • (99374 - 99380) care plan oversight services
  • (99381 - 99429) preventive medicine services
  • (99441 - 99444) non-face-to-face physician services
  • (99450 - 99456) special evaluation & management services
  • (99460 - 99465) newborn care services
  • (99466 - 99480) inpatient neonatal intensive, and pediatric/neonatal critical, care services

Codes for Anaesthesia: 00100-01999; 99100-99150

  • (00100 - 00222) head
  • (00300 - 00352) neck
  • (00400 - 00474) thorax
  • (00500 - 00580) intrathoracic
  • (00600 - 00670) spine & spinal cord
  • (00700 - 00797) upper abdomen
  • (00800 - 00882) lower abdomen
  • (00902 - 00952) perineum
  • (01112 - 01190) pelvis (except hip)
  • (01200 - 01274) upper leg (except knee)
  • (01320 - 01444) knee & popliteal area
  • (01462 - 01522) lower leg (below knee)
  • (01610 - 01682) shoulder & axilla
  • (01710 - 01782) upper arm & elbow
  • (01810 - 01860) forearm, wrist & hand
  • (01916 - 01936) radiological procedures
  • (01951 - 01953) burn excisions or debridement
  • (01958 - 01969) obstetric
  • (01990 - 01999) other procedures

Codes for Surgery: 10021-69990

Codes for Radiology: 70010-79999

  • (70010 - 76499) diagnostic imaging
  • (76506 - 76999) diagnostic ultrasound
  • (77001 - 77032) radiologic guidance
  • (77051 - 77059) breast mammography
  • (77071 - 77084) bone/joint studies
  • (77261 - 77799) radiation oncology
  • (78000 - 79999) nuclear medicine

Codes for Pathology & Laboratory: 80047-89398

  • (80047 - 80076) organ or disease-oriented panels
  • (80100 - 80103) drug testing
  • (80150 - 80299) therapeutic drug assays
  • (80400 - 80440) evocative/suppression testing
  • (80500 - 80502) consultations (clinical pathology)
  • (81000 - 81099) urinalysis
  • (82000 - 84999) chemistry
  • (85002 - 85999) hematology & coagulation
  • (86000 - 86849) immunology
  • (86850 - 86999) transfusion medicine
  • (87001 - 87999) microbiology
  • (88000 - 88099) anatomic pathology (postmortem)
  • (88104 - 88199) cytopathology
  • (88230 - 88299) cytogenetic studies
  • (88300 - 88399) surgical pathology
  • (88720 - 88741) in vivo (transcutaneous) lab procedures
  • (89049 - 89240) other procedures
  • (89250 - 89398) reproductive medicine procedures

Codes for Medicine: 90281-99189; 99500-99607

  • (90281 - 90399) immune globulins, serum or recombinant prods
  • (90465 - 90474) immunization administration for vaccines/toxoids
  • (90476 - 90749) vaccines, toxoids
  • (90801 - 90899) psychiatry
  • (90901 - 90911) biofeedback
  • (90935 - 90999) dialysis
  • (91000 - 91299) gastroenterology
  • (92002 - 92499) ophthalmology
  • (92502 - 92700) special otorhinolaryngologic services
  • (92950 - 93799) cardiovascular
  • (93875 - 93990) noninvasive vascular diagnostic studies
  • (94002 - 94799) pulmonary
  • (95004 - 95199) allergy & clinical immunology
  • (95250 - 95251) endocrinology
  • (95803 - 96020) neurology & neuromuscular procedures
  • (96101 - 96125) central nervous system assessments/tests (neuro-cognitive, mental status, speech testing)
  • (96150 - 96155) health & behavior assessment/intervention
  • (96360 - 96549) hydration, therapeutic, prophylactic, diagnostic injections & infusions, and chemotherapy & other highly complex drug or highly complex biologic agent administration
  • (96567 - 96571) photodynamic therapy
  • (96900 - 96999) special dermatological procedures
  • (97001 - 97799) physical medicine & rehabilitation
  • (97802 - 97804) medical nutrition therapy
  • (97810 - 97814) acupuncture
  • (98925 - 98929) osteopathic manipulative treatment
  • (98940 - 98943) chiropractic manipulative treatment
  • (98960 - 98962) education & training for patient self-management
  • (98966 - 98969) non-face-to-face nonphysician services
  • (99000 - 99091) special services, procedures and reports
  • (99100 - 99140) qualifying circumstances for anesthesia
  • (99143 - 99150) moderate (conscious) sedation
  • (99170 - 99199) other services & procedures
  • (99500 - 99602) home health procedures/services
  • (99605 - 99607) medication therapy management services

Category II

  • Category II CPT Code(s) – Performance Measurement (optional)[7] (Category II codes: 0001F-7025F)

Category III

  • Category III CPT Code(s) – Emerging Technology (Category III codes: 0016T-0207T[8])

Copyright

CPT is a registered trademark of the American Medical Association., and the AMA holds the copyright for the CPT coding system.[9]

Despite the copyrighted nature of the CPT code sets, the use of the code is mandated by almost all health insurance payment and information systems, including by Centers for Medicare & Medicaid Services (CMS) and HIPAA, and the data for it appear in the Federal Register. As a result, it is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code. [10]

Limited CPT Search Offered by the AMA

The AMA offers a limited search of the CPT manual for personal, non-commercial use on its website:

https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do

See also

References

  1. ^ AMA (CPT) CPT Process
  2. ^ Laura Southard Durham (1 June 2008). Lippincott Williams & Wilkins' Administrative Medical Assisting. Lippincott Williams & Wilkins. pp. 2–. ISBN 9780781797894. http://books.google.com/books?id=b9NyTDdaEEsC&pg=RA2-PA102. Retrieved 26 May 2011. 
  3. ^ Michelle Abraham; Jay T. Ahlman; Angela J. Boudreau; Judy L. Connelly, Desiree D. Evans, Rejina L Glenn (30 October 2010). CPT 2011 Standard Edition. American Medical Association Press. ISBN 9781603592161. http://books.google.com/books?id=vZv5RQAACAAJ. Retrieved 26 May 2011. 
  4. ^ American Medical Association; American Medical Association (COR); Michelle Abraham; Jay T. Ahlman, Angela J. Boudreau, Judy L. Connelly (30 October 2010). CPT 2011 Professional Edition. American Medical Association Press. ISBN 9781603592178. http://books.google.com/books?id=-FP1RQAACAAJ. Retrieved 26 May 2011. 
  5. ^ Centers for Medicare & Medicaid Services
  6. ^ Marie A. Moisio (8 April 2009). Medical Terminology for Insurance and Coding. Cengage Learning. pp. 80–. ISBN 9781428304260. http://books.google.com/books?id=HjYEikV_n6MC&pg=PA80. Retrieved 26 May 2011. 
  7. ^ Holly Hosford-Dunn; Ross J. Roeser; Michael Valente (2008). Audiology practice management. Thieme. pp. 323–. ISBN 9783131164124. http://books.google.com/books?id=r2wBJFACx0wC&pg=PA323. Retrieved 26 May 2011. 
  8. ^ CPT 2010
  9. ^ AMA (CPT) CPT Licensing
  10. ^ http://www.ama-assn.org/ama1/pub/upload/mm/37/2009-annual-report.pdf

External links


Wikimedia Foundation. 2010.

Look at other dictionaries:

  • CPT — Carriage Paid To (Business » International Business) Captain (Governmental » Military) Captain (Governmental » US Government) ** Current Procedural Terminology (Medical) ** Current Procedural Terminology (Medical » Hospitals) * Cape Town, South… …   Abbreviations dictionary

  • Medical classification — Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers. The diagnoses and procedures are usually taken from a variety of sources within the… …   Wikipedia

  • Healthcare Common Procedure Coding System — The Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes based on the American Medical Association s Current Procedural Terminology (CPT). Commonly pronounced Hicks Picks .The Healthcare Common Procedure… …   Wikipedia

  • Clinical Care Classification System — The Clinical Care Classification (CCC) System is a standardized, coded nursing terminology that identifies the discrete elements of nursing practice. The CCC provides a unique framework and coding structure for documenting the plan of care… …   Wikipedia

  • ICD — The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social… …   Wikipedia

  • Department of Defense Serum Repository — Interior of the United States Department of Defense Serum Repository (DoDSR). The Department of Defense Serum Repository (also referred to as the DoD Serum Repository or simply DoDSR) is a biological repository operated by the United States… …   Wikipedia

  • MEDCIN — MEDCIN, a system of standardized medical terminology, is a proprietary medical vocabulary and was developed by [http://www.medicomp.com Medicomp Systems, Inc.] MEDCIN is a point of care terminology, intended for use in Electronic Health Record… …   Wikipedia

  • Procedure codes — are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals. Contents 1 Examples of procedure codes 1.1 International 1.2 North American 1.3 European …   Wikipedia

  • Resource-Based Relative Value Scale — (RBRVS) is a schema used to determine how much money medical providers should be paid. It is currently used by Medicare in the United States and by nearly every Health maintenance organizations (HMOs).RBRVS assigns procedures performed by a… …   Wikipedia

  • CPT — or Cpt may stand for: Captain (disambiguation) (Cpt.), a rank or title CBS Paramount Television, a former TV branch of CBS now known as CBS Television Studios Certified Penetration Tester, a penetration testing certification offered by the IACRB… …   Wikipedia


Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”

We are using cookies for the best presentation of our site. Continuing to use this site, you agree with this.