Current Procedural Terminology

Written by Norene Anderson
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Current Procedural Terminology (CPT) is the standard set by the American Medical Association in the 1960s for identifying procedures. It was adopted as the standard for Medicare and Medicaid claims to provide continuity. It was later adopted by managed care companies and private insurance carriers.

CPT (Current Procedural Terminology) codes provide a description of surgical, medical, and diagnostic services that is used nationwide. The consistency of the language provides a clear transmission of activity from the physician to the insurance carrier. It also provides a method of sharing accurate patient data with other caregivers. This coding is specific and leaves no room for guessing. There are modifiers to further enhance the description of the code.

Current Procedural Terminology Changes

The Current Procedural Terminology book has evolved from the first edition containing mostly surgical procedures to an expanded second edition in 1970. This expanded edition included diagnostic procedures and therapeutic procedures in specialties other than surgery. The coding system went from four digits to five digits. Updated editions are available. The use of the CPT codes has become the standard for the Centers for Medicare and Medicaid Services and other procedure reporting entities.

HIPAA requires a standardized reporting for electronic transactions and CPT coding is part of that requirement. Codes and modifiers are used for reporting lab tests, radiology services, physician services, and many other procedures. The CPT codes are maintained by an editorial panel consisting of 17 members with five of these members comprising an executive committee. Input is received from a variety of physicians and other healthcare professionals.


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