CPT Process

Current Procedural Terminology (CPT) was first developed in 1966 by the American Medical Association (AMA). It serves as a uniform, descriptive medical code set used across the country for coding medical services; this assists in streamlining reporting and increasing accuracy and efficiency. CPT codes are updated annually and effective for use on Jan. 1 of each year. The AMA prepares each annual update so new CPT books are available in the preceding fall of each year to allow for implementation in the new year.

The CPT Editorial Panel is charged with creating all terminology and definitions for the medical services and procedures performed in the United States. They also ensure CPT codes remain up-to-date and reflect the latest in medical care. The Panel maintains an open process, convenes meetings three times a year, and solicits the input of practicing physicians, medical device manufacturers, developers of diagnostic tests, and advisors from medical societies.

Category 1: Procedures and contemporary medical practices 

Category 1 covers procedures and contemporary medical practices that are widely preformed. This section is usually being referred to when talking about CPT and consists of five digit numeric codes that identify a procedure or service that is approved by the FDA, performed by health care professionals, and is documented.

Category 1 codes are broken down into six sections:

Category 2: Clinical laboratory services 

Category 2 codes are supplementary tracking codes that are used for performance measures and intended to help collect information about the quality of care delivered. This medical code is optional and not a substitute for Category 1 codes.

Category 3: Emerging technologies, services, and procedures 

Category 3 codes are temporary codes that cover emerging technologies, services, and procedures. They differ from Category 1 in that they identify services that may not be widely performed by health care professionals, have yet to receive FDA approval, or may not have proven clinical efficacy. To be eligible for these codes, the service or procedure must be involved in ongoing and planned research.