AccuLibrary
AccuChecker
Subject: Understanding CPT
The
Current Procedural Terminology {CPT } code set is a medical code set maintained
by the American Medical Association { AMA }. The code set is registered / copyright
and protected by the AMA.
Category
I
Codes
for Evaluation and Management { E/M }
99201-99215 Office/other outpatient services
99217-99220 Hospital Observation Services
99221-99239 Hospital Inpatient Services
99241-99255 Consultations
99281-99288 Emergency Room Department Services
99291-99292 Critical Care Services
99304-99318 Nursing Facility Services
99324-99337 Domiciliary, rest home, boarding home, or
custodial care services
99339-99340 Domiciliary, rest home, ALF, or home care
plan oversight services
99341-99350 Home Health Services
99354-99360 Prolonged Services
99363-99368 Case Management Services
99374-99380 Care Plan Oversight Services
99381-99429 Preventive Medicine Services
99441-9444 Non-face-to-face Physician Services
99450-99456
SPECIAL Evaluation and Management {E/M }
Services
99460-99465 Newborn Care Services
99466-99480 Inpatient neonatal intensive and
pediatric/neonatal critical care services
99487-99489 Complex chronic care coordination services
99495-99496 Transitional Care Management Services
99499 OTHER Evaluation and Management
Services
CODES FOR
ANESTHESIA
Range: 00100-01999, 99100-99150
00100-00222 Head
00300-00352 Neck
00400-00474 Thorax
00500-00580 Intrathoracic
0060-00670 Spine and Spinal Cord
00700-0797 Upper Abdomen
00800-00882 Lower Abdomen
00902-00952 Perinueum
01112-01190 Pelvis (except HIP)
01200-01274 Upper Leg (except Knee)
01320-01444 Knee and Popliteal Area
01610-01682 Shoulder and Axillary
01710-01782 Upper Arm and Elbow
01810-01860 Forearm, Wrist, Hand
01916-01936 Radiological Procedures
01951-01953 Burn Excisions or Debridement
01958-01969 Obstetric
01990-99140 Other Procedure
99100-99140 Qualifying Circumstances for Anesthesia
99143-99150 Moderate conscious Sedation
CODES FOR
SURGERY
Range: 10021-69990
10021-10022 General
10040-19499 Integumentary System
20000-29999 Musculoskeletal System
30000-32999 Respiratory System
38100-38999 Hemic and Lymphatic Systems
39000-39599 Mediastinum and Diaphragm
40490-49999 Digestive System
50010-53899 Urinary System
54000-55899 Male Genital System
55920-55980 Reproductive System and Intersex
56405-58999 Female Genital System
59000-59899 Maternity Care and Delivery
60000-60699 Endocrine System
65091-68899 Eye and Ocular Adnexa
69000-69979 Auditory System
CODES FOR
RADIOLOGY
Range: 70010-79999
70010-76499 Diagnostic Imaging
76506-76999 Diagnostic Ultrasound
77001-77032 Radiologic Guidance
77051-77059 Breast Mammography
77071-77084 Bone / Joint Studies
77261-77799 Radiation Oncolok
CODES FOR
PATHOLOGY AND LABORATORY
Range: 80047-89398
80047-80076 Organ or Disease-oriented Panels
80100-80103 Drug Testing
80150-80299 Therapeutic Drug Assays
80400-80440 Evocative/Suppression Testing
80500-80502 Consultations { Clinical Pathology }
81000-81099 Urinalysis
82000-84999 Chemistry
85002-85999 Hematology and Coagulation
86000-86849 Immunology
86850-86999 Transfusion Medicine
87001-87999 Microbiology
88000-88099 Anatomic Pathology
88104-88199 Cytopathology
88230-88299 Cytogenetic Studies
88300-88399 Surgical Pathology
88720-88741 In vivo {transcutaneous} Lab Procedure
89049-89240 Other Procedures
89250-89398
Reproductive Medicine Procedures
CODES FOR
MEDICINE
Range: 90281-99099, 99151-99199,
99500-99607
90281-90399 Immune Globulins, serum or recombinant prods
90465-90474 Immunizations Administration for
Vaccines/Toxoids
90476-90479 Vaccines / Toxoids
90801-90899 Psychiatry
90901-90911 Biofeedback
90935-90999 Dialysis
91000-91299 Gastroenterology
92002-92499 Ophthalmology
92502-92700 Special Otorhinolaryngologic Services
92950-93799 Cardiovascular
93875-93990 Noninvasive Vascular Diagnostic Studies
94002-94799 Pulmonary
95004-95199 Allergy and Clinical Immunology
95250-95251 Endocrinology
95803-90620 Neurology and Neuromuscular Procedures
96101-96125 Central Nervous System assessments/tests
(neuro-cognitive, mental
status, speech testing)
96150-96155 Health and Behavioral Assessment /
Intervention
96360-96549 Hydration, therapeutic, prophylatic,
diagnostic injection and infusions and chemotherapy and other highly complex
drug or highly complex biologic
agent administration
96567-96571 Photodynamic Therapy
97001-97799 Physical Medicine and Rehabilitation
97802-97804 Medical Nutrition Therapy
97810-97814 Acupuncture
98925-98929 Osteopathic Manipulative treatment
98940-98943 Chiropractic Manipulative treatment
98960-98962 Education
and Training for Patient Self-Management
98966-98969 Non-face-to-face nonphysician services
99000-99091 Special Services , Procedures and Reports
99170-99199 Other Services and Procedures
99500-99602 Home Health Procedures / Services
99605-99607 Medication Therapy management Services
Category II
Category II codes are reviewed by the Performance
Measures Advisory Group {PMAG}
These groups consists of:
- Joint Commission (JCAHO)
- National Committee for Quality Assurance (NCQA) [ HEDIS ]
- Agency for Healthcare Research and Quality (AHRQ)
- Physician Quality Reporting (PQRS)
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-4360F
Follow-up or outcomes 5005F-5100F
Patient Safety 6005F-6045F
Structural Measures 7010F-7025F
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