Three categories of CPT codes

Three categories of CPT codes

There are three categories of CPT codes, and they serve different purposes.

Category I

Category I codes describe medical procedures and services, including surgeries, tests, consultations, and treatments. This category is divided into sections based on the healthcare field they apply to. These sections include:

• Evaluation and Management
• Anesthesiology
• Surgery
• Radiology
• Pathology and Laboratory
• Medicine

Each section consists of a range of five-digit numerical codes assigned to specific services. Apart from CPT codes for Evaluation and Management, the codes are listed in numerical order:

• Evaluation and Management: 99201 – 99499
• Anesthesia: 00100 – 01999; 99100 – 99140
• Surgery: 10021 – 69990
• Radiology: 70010 – 79999
• Pathology and Laboratory: 80047 – 89398
• Medicine: 90281 – 99199; 99500 – 99607

For example, some of the CPT codes for counseling are 90832 and 90837, while CPT codes for occupational therapy evaluation are 97165, 97166, and 97167.

Category II

Category II codes are used to track performance measurements and other activities. These codes are used with Category I codes to provide additional information about how the service was provided. For example, a Category II code can indicate whether an experienced professional or a trainee provided a particular treatment or procedure. These CPT codes can't replace Category I or III codes but rather they provide extra information. They typically contain five characters – the first four numerical characters followed by a fifth alphabetical character, "F":

• Composite Measures 0001F – 0015F
• Patient Management 0500F – 0575F
• Patient History 1000F – 1220F
• Physical Examination 2000F – 2050F
• Diagnostic/Screening Processes or Results 3006F – 3573F
• Therapeutic, Preventive, or Other Interventions 4000F – 4306F
• Follow-Up or Other Outcomes 5005F – 5100F
• Patient Safety 6005F – 6045F • Structural 7010F – 7025

Category III

Category III CPT codes report emerging medical services and technologies that don't fit the existing categories. They are used to accurately track new developments in healthcare delivery, such as robotic surgery or teledermatology. These codes are designed to provide more specificity in coding, and they also help facilities and organizations track the effectiveness of new, emergent medical techniques. Category III codes may eventually be incorporated into Category I codes if they become widely used or if there is a need for greater specificity. For example, some of the current Category III CPT codes include 94999 for unspecified medical procedures or services and 95930 for biofeedback training

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