Current Procedural Terminology

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The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel.[1] The CPT code set (copyright protected by the AMA) 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 2013. 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. ICD code sets also contain procedure codes but these are only used in the inpatient setting.[5]

CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS) [6] as Level 1 of the Health Care Procedure Coding System.

The Current Procedural Terminology (CPT) was developed by the American Medical Association (AMA)
[6]

Types of code[edit source | edit]

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

Category I[edit source | edit]

Category I CPT Code(s). There are six main sections:[7]

Codes for Evaluation and Management: 99201-99499[edit source | edit]

Codes for Anesthesia: 00100-01999; 99100-99150[edit source | edit]

Codes for Surgery: 10021-69990[edit source | edit]

Codes for Radiology: 70010-79999[edit source | edit]

Codes for Pathology & Laboratory: 80047-89398[edit source | edit]

Codes for Medicine: 90281-99199; 99500-99607[edit source | edit]

Category II[edit source | edit]

  • Category II CPT Code(s) – Performance Measurement (optional)[8] (Category II codes: 0001F-7025F)

Category III[edit source | edit]

  • Category III CPT Code(s) – Emerging Technology (Category III codes: 0016T-0207T[9])

Major Psychotherapy Revisions[edit source | edit]

The CPT code revisions that effect counselors are simple and straightforward. Here is a list of psychotherapy CPT codes that will be retired, and their 2013 comparables:

90801 –> 90791 (diagnostic evaluation without medical services) 90804 –> 90832 (was 20–30 minutes psychotherapy, now 30 minutes) 90806 –> 90834 (was 45–50 minutes psychotherapy, now 45 minutes) 90808 –> 90837 (was 75–80 minutes psychotherapy, now 60 minutes)

Family therapy codes (90847 and 90846) will remain unchanged, as will codes for psychological testing.[10]

Copyright[edit source | edit]

CPT is a registered trademark of the American Medical Association. The AMA holds the copyright for the CPT coding system.[11]

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 the Centers for Medicare and Medicaid Services (CMS) and HIPAA, and the data for the code sets appears 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.[12]

Limited CPT search offered by the AMA[edit source | edit]

The AMA offers a limited search of the CPT manual for personal, non-commercial use on its web site.[13]

See also[edit source | edit]

References[edit source | edit]

  1. ^ AMA (CPT) CPT Process
  2. ^ Laura Southard Durham (1 June 2008). Lippincott Williams & Wilkins' Administrative Medical Assisting. Lippincott Williams & Wilkins. pp. 2–. ISBN 978-0-7817-9789-4. 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 978-1-60359-216-1. 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 978-1-60359-217-8. Retrieved 26 May 2011. 
  5. ^ Alexander, Sherri, Pharm.D. (1 November 2003). "Overview of inpatient coding". American Journal of Health-System Pharmacy 60. Retrieved 30 April 2013. 
  6. ^ a b Centers for Medicare & Medicaid Services
  7. ^ Marie A. Moisio (8 April 2009). Medical Terminology for Insurance and Coding. Cengage Learning. pp. 80–. ISBN 978-1-4283-0426-0. Retrieved 26 May 2011. 
  8. ^ Holly Hosford-Dunn; Ross J. Roeser; Michael Valente (2008). Audiology practice management. Thieme. pp. 323–. ISBN 978-3-13-116412-4. Retrieved 26 May 2011. 
  9. ^ CPT 2010
  10. ^ Centore, Anthony. "2013 CPT Code Revisions". Thriveworks.com. Retrieved 6 February 2013. 
  11. ^ AMA (CPT) CPT Licensing
  12. ^ http://www.ama-assn.org/ama1/pub/upload/mm/37/2009-annual-report.pdf
  13. ^ AMA (2012). "cpt® Code/Relative Value Search". Retrieved from https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do.

External links[edit source | edit]
Topographical codes
TA · TH · TE · SNOMED T axis · MeSH A axis
Diagnostic codes

general: ICD-10 · ICD-9 · ICPC-2 · NANDA · Read codes · SNOMED D axis

specialized: ICD-O · ICSD · ICHD · ILDS · DSM-IV · BPA
Procedural codes
Pharmaceutical codes
ATC · NDC · SNOMED C axis · DIN
Outcomes codes
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