How is the CPT coding system organized?

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The CPT (Current Procedural Terminology) coding system, maintained by the American Medical Association (AMA), is used to describe medical, surgical, and diagnostic services for billing and documentation in the U.S. healthcare system.

CPT Code Structure:

  • Each CPT code is a 5-digit numeric code (e.g., 99213).

  • Codes are organized into three main categories

Category I: Main Procedural Codes

  • Most commonly used.

  • Divided into 6 sections, each with a range of codes:

    1. Evaluation and Management (99201–99499) – Office visits, consultations

    2. Anesthesia (00100–01999) – Anesthesia services

    3. Surgery (10021–69990) – All surgical procedures

    4. Radiology (70010–79999) – Imaging procedures

    5. Pathology and Laboratory (80047–89398) – Lab tests

    6. Medicine (90281–99607) – Non-surgical services (e.g., vaccines, psychiatry)

Each code includes a description of the service, used by healthcare providers for accurate billing.

Category II: Performance Measurement Codes

  • Optional tracking codes for quality improvement.

  • Format: 4 digits + letter 'F' (e.g., 0005F).

  • Not used for reimbursement.

Category III: Emerging Technology Codes

  • Temporary codes for new or experimental procedures.

  • Format: 4 digits + letter 'T' (e.g., 0075T).

Summary:

CPT codes are organized by medical specialty and purpose, allowing standardized documentation and billing. Category I codes are the most commonly used, while Category II and III support quality tracking and innovation.

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