What is it?
CPT stands for Current Procedural Terminology. It is a set of codes created by the American Medical Association (AMA) to standardize how medical procedures are recorded in a medical chart.
Why is it used?
CPT codes are one of the primary ways that both public and private medical providers and healthcare institutions can report the services they have provided to patients to the government and insurance companies for reimbursement purposes. CPT codes are part of the national coding system under the Health Information Portability and Accountability Act (HIPAA).
How is it maintained?
CPT codes are maintained by the CPT Editorial Board, a part of the AMA, and are updated once a year. The new codes are released annually in November, and go into effect on the following January 1. The editorial board meets three times a year to review applications for new codes.
What do the codes look like?
CPT codes are five characters long and are usually numeric, although some may be alphanumeric depending on what category they fall into.
What are the “categories” you mentioned?
The CPT manual is divided into three categories, each with distinct purposes outlined below:
- Used to report the devices and drugs used during a procedure
- Used to report the procedure itself to the billing department
- Contains the billable codes needed for reimbursement
- Designed for reporting performance measures
- Used to provide data to regulatory agencies
- Does not contain billing codes
- Primarily thought of as “quality of care” codes
- Codes for documenting new procedures, clinical trials and emerging technologies
- Must be either added to Category I or deleted within five years of being added
We offer a portfolio of products that includes terminologies and value sets that are clinically vetted, always current, and maintenance-free. This aligns to provider organizations’ missions, EHR platforms’ inherent power, and the evolving vision of the healthcare industry while ensuring accurate care documentation and administrative codes. So clinicians can get back to being clinicians, health systems can get reimbursed, and patients can more easily engage in their own care. As intended.
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