CPT Code
CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedure performed by a healthcare provider on a patient. Choosing and assigning the correct cpt diagnosis code ensure the efficient and accurate processing of your medical claims.
A good reason to understand CPT codes is so you can make sense of your hospital bill and catch any billing errors. Check your cpt code in here.Try to take the time to review your bill carefully and compare it with your EOB to check for any errors. Healthcare providers or facilities can make typographical errors, coding for the wrong type of visit or service.
CPT codes are used for reporting devices and drugs (including vaccines) required for the performance of a service or procedure, services or procedures performed by physicians and other health care providers, services or procedures performed intended for clinical use, services or procedures performed according to current medical practice, and services or procedures that meet CPT requirements. These codes are billable for reimbursement.
There are 10 main CPT sections:
00000-09999 | Anesthesia Services |
10000-19999 | Integumentary System |
20000-29999 | Musculoskeletal System |
30000-39999 | Respiratory, Cardiovascular, Hemic, and Lymphatic System |
40000-49999 | Digestive System |
50000-59999 | Urinary, Male Genital, Female Genital, Maternity Care, and Delivery System |
60000-69999 | Endocrine, Nervous, Eye and Ocular Adnexa, Auditory System |
70000-79999 | Radiology Services |
80000-89999 | Pathology and Laboratory Services |
90000-99999 | Evaluation & Management Services |
CPT Code List:
Select starting letter or number from the list :Last Checked CPT Codes By Doctors
CPT Categories
CPT codes 'Category' refers to the division of the code set.
Category I
- Evaluation and Management: 99201 - 99499
- Anesthesia: 00100 - 01999; 99100 - 99140
- Surgery: 10021 - 69990
- Radiology: 70010 - 79999
- Pathology and Laboratory: 80047 - 89398
- Medicine: 90281 - 99199; 99500 - 99607
Category I CPT codes are numeric, and are five digits long.
Category II
These codes are five character-long, alphanumeric codes that provide additional information to the Category I codes. These codes are formatted to have four digits, followed by the character F.
- Composite codes
- These codes combine a number of procedures that typically occur in conjunction with one main procedure.
- Example: 0001F: heart failure assessed (includes all of the following):
- Blood pressure measured
- Level of activity assessed
- Clinical symptoms of volume overload assessed
- Weight recorded
- Clinical signs of volume overload assessed
- Example: 0001F: heart failure assessed (includes all of the following):
- Patient Management
- Includes patient care provided for specific clinical purposes like pre- and postnatal care.
- Example: 0503F: Postpartum care visit
- Includes patient care provided for specific clinical purposes like pre- and postnatal care.
- Patient History
- Describes measures for select elements of patient history or symptom review
- Example: 1030F: Pneumococcus immunization status assessed
- Describes measures for select elements of patient history or symptom review
- Physical Examination
- Example: 2014F: Mental status assessed
- Diagnostic/Screening Processes or Results
- Includes results of tests ordered, including clinical lab tests and radiological procedures
- Example: 3006F: Chest X-ray documented and reviewed
- Includes results of tests ordered, including clinical lab tests and radiological procedures
- Therapeutic, Preventive, or Other Interventions
- Describes pharmacologic, procedural or behavioral therapies
- Example: 4037F: influenza immunization ordered or administered
- Describes pharmacologic, procedural or behavioral therapies
- Follow-up or Other Outcomes
- These codes describe the review and communication of test results to a patient, patient satisfaction, patient functional status, and patient morbidity or mortality
- Example: 5005F: patient counseled on self-examination for new or changing moles
- These codes describe the review and communication of test results to a patient, patient satisfaction, patient functional status, and patient morbidity or mortality
- Patient Safety
- Includes codes that describe patient safety precautions
- Example: 6015F: Patient receiving or eligible to receive foods, fluids, or medication by mouth
- Includes codes that describe patient safety precautions
- Structural Measures
- This short section includes codes that describe the setting of the delivered care, and also covers the capabilities of the healthcare provider
- Example: 7025F: patient information entered into a reminder system with a target due date for the next mammogram
- This short section includes codes that describe the setting of the delivered care, and also covers the capabilities of the healthcare provider
- These codes combine a number of procedures that typically occur in conjunction with one main procedure.
Category III
Category III codes allow for more specificity in coding. Cat-3 CPT codes is made up of temporary codes that represent emergent or experimental services, technology, and procedures.Category III codes are archived in the CPT manual for five years.
Patient Status Codes
Using CPT code in billing form requires patient status codes. They are :
01 | Discharge to home or self-care (routine discharge) |
02 | Discharge/transfer to short-term general hospital |
03 | Discharge/transfer to SNF |
04 | Discharge/transfer to ICF |
05 | Discharge/transfer to a designated cancer center or children's hospital |
06 | Discharge/transfer to home care of another HHA OR discharge and readmit to the same HHA within a 60-day episode |
07 | Left against medical advice or discontinued care |
20 | Expired - Occurrence code 55 also required. |
21 | Discharge/transfer to court/law enforcement |
30 | Still a patient. Services continue to be provided. (Required on RAPs.) |
43 | Discharge/transfer to federal hospital |
50 | Discharge/transfer for hospice services in the home |
51 | Discharge/transfer to hospice services in a medical facility |
62 | Discharge/transfer to IRF (inpatient rehabilitation facility) |
63 | Discharge/transfer to long-term care hospital |
65 | Discharge/transfer to psychiatric hospital or psychiatric part unit of a hospital |
66 | Discharge/transfer to Critical Access Hospital (CAH) |
70 | Discharge/transfer to another type of health care institution not defined elsewhere in code list |
81 | Discharged to home or self-care with a planned acute care hospital inpatient readmission (effective 10/1/13) |
82 | Discharged/transferred to a short-term general hospital for inpatient care with a planned acute care hospital inpatient readmission (effective 10/1/13) |
83 | Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission (effective 10/1/13) |
84 | Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission (effective 10/1/13) |
85 | Discharged/transferred to a designated cancer center or children's hospital with a planned acute care hospital inpatient readmission (effective 10/1/13) |
86 | Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care with a planned acute care hospital inpatient readmission (effective 10/1/13) |
87 | Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission (effective 10/1/13) |
88 | Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission (effective 10/1/13) |
89 | Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission (effective 10/1/13) |
90 | Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13) |
91 | Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission (effective 10/1/13) |
92 | Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission (effective 10/1/13) |
93 | Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13) |
94 | Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission (effective 10/1/13) |
95 | Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission (effective 10/1/13) |
96-99 | Reserved for national assignment |
CPT Condition Codes
07 | Treatment of nonterminal condition for hospice patient |
20 | eneficiary requested billing (demand denial) |
21 | Billing for denial notice (no-pay bill) |
47 | Transfer from another HHA |
54 | No skilled HH visits in billing period. |
C3 | Expedited review - partial approval of Medicare-covered services |
C4 | Expedited review - services denied |
C7 | Expedited review extended authorization of Medicare-covered services |
Most Expensive CPT Codes:
We have listed the most expensive CPT codes according to medical bill from several hospitals and insurance companies yearly book.
Code : | Description: | Number Of Procedures: |
---|---|---|
S2067 | Breast stacked "diep/gap" | 109 |
C1882 | AICD, other than sing/dual | 134 |
J7330 | Cultured chondrocytes implnt | 555 |
J1300 | Eculizumab injection | 273 |
C1722 | AICD, single chamber | 69 |
Q2043 | Sipuleucel-T auto CD54+ | 95 |
J0221 | Lumizyme injection | 24 |
C9733 | Non-ophthalmic FVA | 48 |
55970 | Sex Transformation M to F | 35 |
S2068 | Breast DIEP or SIEA flap | 641 |
J2350 | Injection, ocrelizumab, 1 mg | 494 |
33264 | Removal & replacement of defibrillator generator; multiple lead system | 986 |
J0202 | Injection, alemtuzumab | 16 |
C1721 | AICD, dual chamber | 138 |
33263 | Removal & replacement of defibrillator generator; dual lead | 670 |
33249 | Insertion/replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s) | 2,968 |
L8614 | Cochlear device | 594 |
C9600 | Percutaneous transcatheter placement of drug-eluting intracoronary stent; single major coronary artery or branch | 371 |
69930 | Implant cochlear device | 1,515 |
J3385 | Velaglucerase alfa | 147 |
L8687 | Implant neurostimulator pulse generator, dual array, rechargeable | 2,318 |
33262 | Removal & replacement of defibrillator generator; single lead | 201 |
0375T | Total disc arthroplasty anterior approach | 15 |
L8688 | Implant neurostimulator pulse generator, dual array, non-rechargeable | 727 |
L5856 | Elec knee-shin swing/stance | 16 |