CPT stands for Current Procedural Terminology. In other words, these are medical procedure codes. They're used to indicate what types of procedures have been performed so insurance companies can pay bills correctly, and statistics can easily be tracked. These codes are managed by the AMA, or American Medical Association, on a yearly basis. They have a set of guidelines for each of the six main categories of CPT codes that help instruct how they're to be used, as well as clarifying guidelines for the subcategories of each level.
CPT entails coding approved by the AMA
Evaluation and Management
Evaluation and management codes are also known as E&M codes. These codes are used to indicate who is seeing the patient and what level of care the patient is getting. The codes in this category cover physician's offices, clinics, inpatient visits and emergency room visit charges. The AMA guidelines in this category address things such as definitions between new and existing patients, levels of complaints and services, a patient's history with that physician and examination times.
Anesthesia
The anesthesia guidelines are short because there aren't a lot of anesthesia charges. These CPT codes address either which part of the body required anesthesia or services that might have required a different level of anesthesia, such as treating burns. The guidelines concern reporting how long anesthesia was given, the types of anesthesia and the types of procedures.
Surgery
Surgery has the most number of CPT codes for any category. The guidelines cover topics that can be complicated. One guideline tells users combine some of these codes with E&M codes when necessary. Another says determine which charges can and cannot be billed together. A third explains the differences between diagnostic and therapeutic services.
Radiology
Radiology encompasses scanning services, including obstetrical scanning, nuclear medicine and arteriograms. The guidelines show when these services are charged as separate procedures or as part of a more complicated procedure.
Laboratory
The laboratory has one page of guidelines as a whole, and not many guidelines for specific groups of lab tests, either. The main guideline is for determining which tests must be bundled, which means billed under one CPT number instead of multiple numbers for multiple tests. The secondary guideline is determining which lab test is primary when certain groups of tests are performed.
Medicine
The medicine area of the CPT manual is the most diverse as far as services are concerned, but the guidelines for the department are sparse. The main guideline is determining which service is actually being performed, as many of the CPT groups can seem similar based on wording, but are totally separate items. Most of the guidelines are contained within each subsection since this category contains so many different types of services.
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