Describing Cpt Coding Categories

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HCR 220 CHECKPOINT

The CPT codes have three categories: Category 1, Category 2, and Category 3. Key words for using the three code categories are “temporary”, “common,” and “optional.” Because Category 1 is the most used, it can be referred by to common codes. Category 2 is optional codes and Category 3 is temporary codes. Codes in Category 1 have five digits and no decimals. Category 1 codes represent procedures that are widely performed and are consistent with the current practice of medicine. Doctors and most outpatient care providers use these codes. Codes in Category 1 are updated annually. They are divided into six sections: 1. Evaluation and Management

2. Anesthesiology
3. Surgery
4. Radiology
5. Pathology and Laboratory
6. Medicine
An example of Category 1:
* 9999253 Initial inpatient consultation
When tracking performance measures for the purpose of a medical goal, Category 2 codes are used. Category 2 codes are optional and not paid by insurance carriers. They contain an alphabetic character in the place of the fifth digit. An example of Category 2:

* 0002F Tobacco use, smoking, assessed
Category 3 codes are temporary codes used for emerging procedures, technologies, and services. Category 3 codes also use alphabetic codes for the fifth digit. Example of Category 3: * 0058T Cryopreservation, reproductive tissue, ovarian

There is an easier way to explain this information to employees: Category 1 (common) are used for everything we code; Category 2 (optional) is only used to track our performance measures and do not have to be used, Category 3 (temporary) is used for emerging technology, services, and procedures.
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