Cpt® Code
A CPT® code is a standardized code created by the American Medical Association (AMA) to report medical, surgical, and diagnostic services and procedures for reimbursement.
What is a Cpt® Code?
A CPT® code is a Current Procedural Terminology code. These codes offer doctors and health care professionals a uniform language for coding medical services and procedures. This standardization helps to streamline reporting and increase accuracy and efficiency in the healthcare system.
The use of CPT® codes is crucial for various aspects of healthcare, including billing, claims processing, and data analysis. By providing a consistent way to describe medical services, CPT® codes facilitate communication between providers, payers, and patients, ultimately contributing to a more organized and understandable healthcare landscape.
What is the difference between a Cpt® Code and HCPCS code?
CPT codes and HCPCS codes are both used in medical coding, but they differ in purpose, ownership, and structure. CPT codes, maintained by the AMA, describe medical services and procedures and are typically five-digit numeric codes. HCPCS codes, developed by CMS, are primarily used for Medicare and Medicaid to report products, supplies, and services not included in CPT, often having an alphanumeric structure.
Ownership: CPT codes are developed and maintained by the American Medical Association (AMA) and are copyrighted, whereas HCPCS codes are owned by the Centers for Medicare and Medicaid Services (CMS) and are in the public domain.
Structure: CPT codes are typically five-digit numeric codes, while HCPCS codes, particularly Level II, are alphanumeric.
Scope/Use: CPT codes are universally used by healthcare providers for billing medical services and procedures. HCPCS codes are used to report medical procedures, services, products, and supplies primarily to Medicare, Medicaid, and other insurance programs, with Level II codes covering items not included in CPT.
What are examples of a Cpt® Code?
A patient visits the emergency room for appendicitis. The CPT® codes used would include 99284 for the ER visit, 76705 for a limited abdominal ultrasound, and 44970 for a laparoscopic appendectomy.
A patient presents with upper respiratory symptoms and undergoes a complete blood count (CBC). The CPT® codes would be 99213 for the established patient visit and 85025 for the CBC.
A patient with type 2 diabetes has a follow-up visit and a glycosylated hemoglobin test. The CPT® codes would include 99214 for the established patient visit and 83036 for the glycosylated hemoglobin test.
Let's review your payer contracts side-by-side with the market.
Bring your top billing codes and we'll show you how you compare to your peers in 15 minutes or less.