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.  

Leave a Comment