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CPT Meaning: What Is Its Relevance to Billing?

cpt meaning

Understanding CPT meaning is essential for operating an efficient healthcare practice. However, even professionals with years of medical study can find some terminology to be among the top challenges in revenue cycle management.

That’s why we’ll examine every element of CPT code, including its meaning, different categories, and the five most commonly used codes.

Basic CPT Meaning

CPT stands for Current Procedural Terminology. It is a code system used in medical billing to denote specific medical procedures more efficiently. For example, rather than using a lengthy, technical phrase to describe a complex surgery, medical billers will use either a five-number or alphanumeric code during the billing process. The practice’s billing software then charges patients the appropriate amount based on what code the biller enters.

According to the HIPPA (Health Insurance Portability and Accountability Act), CPT is now the standard billing code across the United States Department of Health. 

CPT Meaning For Each Category

Every CPT code falls within one of three categories, each with a different function.

Category I

Category I CPT codes range everywhere from 00100-99499, depending on the service and sector. 

There are six subsections within Category I CPT, each with its own code range:

  • Surgery – Codes 10021 to 69990
  • Radiology – Codes 70010 to 79999
  • Laboratory and Pathology – Codes 80047 to 89398
  • Anesthesiology – Codes 00100 to 01999 & 99100 to 99140
  • Medicine – Codes 90281 to 99199 & 99500 to 99607
  • Management and Evaluation – 99201 to 99499

Billers use Category I CPT codes more often than Categories II and III codes because they denote a hospital’s six most common sectors. Every procedure included within Category I is an FDA-approved service that most healthcare professionals are qualified to deliver.

Category II

Category II CPT codes, also known as tracking codes are unique compared to Category I because medical billers don’t have to use them. These codes are for internal use to collect data about the strength of the medical services performed inside a practice.

Category III

Medical billers use Category III codes to track data on the procedures and equipment outside the six common fields that Category I codes cover. Unlike Category I, these codes are for unique services that might fall outside FDA approval.

Standard CPT Codes

Many medical billers will spend most days not touching Category II or Category III codes. However, five commonly-occurring codes are essential to know and pop up in hospitals nearly daily.

  • Visits from new patients
  • Visits from existing patients
  • Emergency visits
  • Follow-up procedures
  • Patients seeking consultation from a doctor on the request of another physician 

Call PracticeForces To Understand CPT Meaning Better

Familiarizing yourself with every CPT meaning is difficult enough; you shouldn’t have to suffer through inefficient medical billing on top of it. With PracticeForces, you don’t have to.

Our team offers cutting-edge medical billing solutions trusted by healthcare professionals nationwide. Our program can improve your practice’s efficiency and boost revenue by as much as 40%.

Check out our guide to AR recovery to keep on top of your accounts and billing. Call PracticeForces today at (727) 499-0351 to learn more.

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