Would you be surprised if we told you this entire entry is about Current Procedural Terminology? Yes, this is the very code system that was created by the America Medical Association (AMA) to describe the methodology used to code and submit medical procedures to insurers to have them process and remit payment for your long hours of work, and your dedication to your patients. There are a few “CPT” categories that we think you’d like to know about as well.
The codes in Category 1, are consistent of procedures that are part of the standard U.S. medical practice. The codes in this category range from 00100 to 99199. These codes are then divided even further: There are the ones for the anesthesiology specialty, which range from 00100-01999, then 99100-99140. After that you have medicine, which ranges from 90281-99199, including 99500-99607. Then we find pathology and laboratory, these codes go from 80047-89398, with radiology that takes the chunk from 70010-79999, with surgery occupying the CPTs from 10021-69990. And last, but not least in the group, evaluation and management, which fall into the 99201-99499 codes.
Moving into Category 2, you’ll find the tracking codes, these are used to measure performance and quality of care delivered by the information collected, and these codes are considered “optional”. The codes in the category are alphanumeric, meaning that they cannot replace any of the ones discussed in Category 1.
Jumping into Category 3, we find temporary alphanumeric codes that are given to technology and procedures that are new and emergent within medicine and do not have coverage through the codes in Category 1. The codes in Category 3 are usually used for data collection and assessment to pay for new procedures and services falling outside of the codes mentioned above.
CPT Codes also have a fourth categoric designation which is for Proprietary Laboratory Analyses codes. This is a fairly new designation introduced recently which includes, but is not limited to, Advanced Diagnostic Laboratory Tests, and Clinical Diagnostic Laboratory Tests. These codes are given in agreement between the AMA and the Food and Drug Administration (FDA).
Now that we’ve broken the CPT Codes down all the way to their newest iteration, we’d like to remind you that the Gables Medical Billing team is always available to guide your claims through adjudication, handling all claims submissions, follow-ups, appeals, and payment posting with the dedication your practice deserves.