Current Procedural Terminology (CPT)

CPT codes are classified into 3 categories:

I) Category I - This is the main category of CPT that used by providers to represent their different services and reimburse the payment. Below are the 6 different sections of this category with specialties and CPT range,

1. Anesthesia Services: 00100 – 01999 & 99100 - 99150
2. Surgery: 10004 – 69990
3. Radiology Services: 70010 – 79999
4. Pathology and Laboratory Services: 80047 – 89398
5. Medical Services and Procedures: 90281 - 99199 & 99500 - 99607
6. Evaluation & Management Services (E&M): 99202 – 99499

II) Category II - These CPT codes are always billed with Category I code to represent an extra information about the patient condition. It has billed amount as $0.00 and it is 5 digit alpha numeric code where initial 4 digits are numeric value and 5th one is the Letter 'F'. These codes are divided as follows:

1. Composite Measures: (0001F – 0015F) 
2. Patient Management: (0500F – 0584F)
3. Patient History: (1000F – 1505F)
4. Physical Examination: (2000F – 2060F)
5. Diagnostic/Screening Processes or Results: (3006F – 3776F)
6. Therapeutic, Preventive, or Other Interventions: (4000F – 4563F)
7. Follow-up or Other Outcomes: (5005F – 5250F)
8. Patient Safety: (6005F – 6150F)
9. Structural Measures: (7010F – 7025F)
10. Nonmeasure Code Listing: (9001F – 9007F)

III) Category III - It has CPT range 0042T-0593T. These CPT codes are temporary codes that represent new technologies, services and procedure. It is a 5 digit alpha numeric code where initial 4 digits are numeric value and 5th one is the Letter 'T'. These CPTs are usually denied for medically not necessity or experimental, so always follow insurance guidelines for the reimbursement.  
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10 comments:

  1. can you please Define what is Evaluation & Management Services....

    ReplyDelete
    Replies
    1. These service codes are used when patient health is evaluated and managed. It includes office visits, hospital visits, home services, and preventive medicine services.

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    2. can i consider this as a very Minor services provided by the provider

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    3. Yes, but it is important as well.

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  2. Please Let us know if You guys are making any Video Content about AR Scenarios, that will be helpful for many people.

    ReplyDelete
    Replies
    1. replay what he has asked Team.

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    2. No, we do not make video on AR content.

      Delete
  3. L9999 is a valid code or not

    ReplyDelete
  4. could you please describe the wellness visit in medicare and commerial plan.

    ReplyDelete