Revenue Cycle Insider

Question: Can you clarify the three primary classifications of CPT^® codes and their respective functions for me? I think this would help me in my new position as a medical coder.

Hawaii Subscriber

Answer: CPT^® codes are divided into three distinct groups called Category I, Category II, and Category III codes for medical billing purposes. Here is a breakdown of each:

• Category I encompasses the most frequently used CPT^® codes, representing established medical procedures and services backed by clinical proof. Examples of Category I codes include:
  • Evaluation and management (E/M) services
  • Laboratory and pathology testing
  • Surgical procedures
  • These are the common CPT^® codes you use on a daily basis (office visit codes, procedural codes, MRI codes, etc.)
• Category II codes are tracking codes used mainly for performance management and quality improvement initiatives. They assist healthcare professionals in gathering information on particular services and results. These codes consist of four digits followed by the letter F.
• Category III codes are temporary codes used for new procedures, services, or technology that has not been given a permanent CPT^® code yet. Examples of Category III codes can include experimental procedures or treatments. These codes appear as four digits followed by the letter T.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC