What is the difference between Category I, II, and III CPT codes?

Quality Thought is the best Medical Coding training institute in Hyderabad, renowned for its comprehensive curriculum and expert trainers. Our institute offers in-depth training on all aspects of medical coding, including ICD-10, CPT, HCPCS, and medical billing, designed to prepare students for global certification exams. With a focus on practical knowledge and industry-relevant skills, Quality Thought ensures students gain hands-on experience through real-time projects and case studies.

Located in the heart of Hyderabad, our state-of-the-art facilities and supportive learning environment make Quality Thought the preferred choice for aspirants aiming to build a successful career in healthcare coding. Our certified trainers bring years of industry experience and personalized attention to help students master the complex coding systems used in hospitals, insurance companies, and healthcare organizations.

We also provide placement assistance, helping students secure jobs with leading medical coding companies. If you’re looking for the best Medical Coding training in Hyderabad, Quality Thought stands out by combining quality education, affordable fees, and excellent career support.

Enroll at Quality Thought today and take the first step toward a rewarding career in medical coding!

CPT codes are divided into three categories—Category I, II, and III—each serving a different purpose in medical coding and billing.

Category I: Standard Codes

• These are the most common CPT codes used for reporting established medical procedures and services.

• Organized into six sections: Evaluation & Management, Anesthesia, Surgery, Radiology, Pathology & Laboratory, and Medicine.

• Each code is five numeric digits (e.g., 99213 for an office visit).

• These codes are approved by the AMA and widely accepted by payers for billing and reimbursement.

✅ Used for: Billing routine, medically necessary services
✅ Example: 99214 – Established patient office visit, 25 minutes

Category II: Performance Measurement Codes

• Optional tracking codes used for quality reporting and performance measurement.

• Not used for billing or reimbursement.

• Each code is five characters ending in "F" (e.g., 0005F).

• Often used in value-based care and quality improvement initiatives.

✅ Used for: Reporting data for quality initiatives
✅ Example: 2028F – Blood pressure measured

Category III: Temporary/Emerging Technology Codes

• For new, experimental, or emerging procedures/technologies not yet approved for widespread use.

• Help track usage and gather data for possible Category I inclusion.

• Each code is five characters ending in "T" (e.g., 0075T).

• May or may not be reimbursed by payers.

✅ Used for: New or investigational procedures
✅ Example: 0648T – Automated AI-based diabetic retinopathy detection

Summary:

• Category I = Standard, billable services

• Category II = Quality tracking, not billable

• Category III = Experimental, emerging procedures, limited billing

Read More

What is a modifier in CPT coding? Give an example.

How is the CPT codebook organized?

Visit QUALITY THOUGHT Training in Hyderabad