Current Procedural Terminology

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CPT - Current Procedural Terminology

According to the American Medical Association-AMA, the main provider and the owner of the CPT copyright, the Current Procedural Terminology is a set of terminology standards that used to identify the medical, surgical and diagnostic services and procedures. This set of terminology standards allow proper interoperability between the different elements of the health system, as physicians, patients, health insurance companies, administrators and others. It is used by insurance companies for the reimbursement purpose. There is a law that obligate that the medical billing is to be done on a CPT basis. The AMA published the first edition in 1966, and we are now using the fourth edition of the CPT ©. CPT is not free, it is copyrighted by AMA which also provide continuous guidance to those who use the CPT. It is maintained by the American Medical Association CPT Editorial Panel, that meet three times a year in order to allow continuous development and problem solving [1]. The CPT is divided into three sub-categories: 1. Category I CPT codes [1]: In this category the code consists of two parts: a five digit code + a descriptor nomenclature. In order to include a new code to this category, certain criteria must be matched, which are the procedure/service described by this code must got the Food And Drug Administration-FDA approval, practiced in multiple locations by many health care-providers and is proven to be efficient. 2. Category II CPT codes[1]: This set of codes is alphanumeric, optional and used for performance measurement. This is done through coding certain procedure, services, and/or test results that are considered to be indicators for the quality of the health care. 3. Category III CPT codes[1]: This is a special set of codes which are also alphanumeric, but used to collect data to assess newly introduced procedures/services, in order to get the FDA approval or to spread this procedure/service. So it is used for research propose.

The CPT terminology are updated annually (an example for these updates is that for 2009 [2]), and this updates are published through the CPT© manual. In the manual tables describing the code contain fields for the code itself (numeric or alphanumeric), the title assigned to this code and the description.




References: 1-the American Medical Association official website: www.ama-assn.org. 1-3-2009. 2- Albert Bothe, Jr., MD,FACS; Linda M. Barney, MD ,FACS; and Debra Mariani, CPC, Practice Affairs Associate, Division of Advocacy and Health policy. Current procedural Terminology: Changes for 2009. 2009.


Submitted by : Aly Khalifa