CPT codes, short for Current Procedural Terminology codes, are a medical code set used to report medical, surgical, radiological, diagnostic and therapeutic procedures and services to insurance companies. CPT codes communicate uniform information about medical services and procedures provided to patients among physicians, coders, patients and accreditation organizations.
Key Takeaways:
CPT stands for Current Procedural Terminology. CPT codes are a medical code set maintained by the American Medical Association through the CPT Editorial Panel.
The CPT code set offers doctors, health care professionals, coders and accreditation organizations a uniform language to code medical services and procedures.
There are three types of CPT codes:
The main purposes of CPT codes are:
Current Procedural Terminology codes are 5 digit numeric codes. However, there are some rules regarding the format:
CPT codes are organized into six main sections:
There are also sections for Category II and III codes.
The official source for CPT codes is theAmerican Medical Association’s CPT code book which is updated and published annually.
Some other places to find CPT codes:
New CPT codes can be added each year so it’s important for coders to stay updated.
Finding the correct CPT code requires reading the code descriptions and studying medical documentation to identify the services performed. CPT code lookup tools can also help find codes.
No, CPT codes describe medical services while diagnosis codes report medical conditions and diseases. However, CPT and ICD-10 diagnosis codes are both used for reporting patient encounters.
The AMA publishes an annual CPT Code book that contains a comprehensive list of all active CPT codes. There are also abbreviated CPT code lists available online and free code lookup tools.
The CPT code set is universal and applies to all medical specialties and insurance payers in the United States. Some insurers may not reimburse for certain codes, but the CPT codes themselves are standardized across the country.
In summary, CPT codes are an important part of medical billing and coding to communicate uniform information about medical services rendered by healthcare providers. Understanding CPT codes helps improve medical documentation, streamline billing, and facilitate accurate payment for services.
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