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Coding is essential for complex systems containing numerous data sets. The Healthcare industry is one such system. The American Medical Association (AMA) maintains and develops the current procedural terminology (CPT) (AMA) that includes the description of codes used in such areas as the provision of medical assistance, surgical intrusions, and diagnostic services (Rouse par.1). The codes are grouped using three categories: category I, II, and III. Considering the areas of the CPT application, the paper aims at describing each area, the differentiation between them, and provides examples.
The codes from this category are purposed to codify the wide range of medical-related activities in the United States. The Category I codes provide information about the procedures and services that are sufficiently presented and well-grounded in the appropriate literature as well as approved by the US Food and Drug Administration (FDA) (Bowie 52; Sullivan 7). The Category I have the following sections to cover: Evaluation and Management, Anesthesiology, Surgery, Radiology, Pathology and Laboratory, and Medicine (“2.07: Intro to CPT Coding” par. 11). The code includes five digits, and each section has its range. As an example, the following code can be used: “the code for “management of liver hemorrhage; simple suture of liver wound or injury” is 47350″ (“2.07: Intro to CPT Coding” par. 20). It is the most extensive category of the CPT codes.
The codes that belong to Category II are used to supplements the codes from Category I. Such codes have four digits and the letter F in the end, and it is used to provide valuable information that is not available in Category I (“2.07: Intro to CPT Coding” par. 37). They are needed to provide additional information in a particular situation. As an example, the following code can be used: “if a doctor records a patient’s Body Mass Index (BMI) during a routine checkup … use Category II code 3008F, “Body Mass Index (BMI), documented” (“2.07: Intro to CPT Coding” par. 38). It should be noted that these codes are not aimed at replacing codes from Category I and III.
The codes that fall into this category are considered as temporary because they are used for the technologies or procedures than only emerge and appear to be new to the health care industry. Such codes are good to be used for collecting information that is utilized to support the decision-making process regarding the addition or removal of new technology to or from the standardized health care provider practice (UTHealth/McGovern Medical School par. 7). In other words, CPT Category III contains the pool of temporary codes that should be removed in 5 years from the moment of presentation in the case the initial code requestors do not want to use the code for further. In this case, it is necessary to propose it to be used as the Category III or Category I code. As an example, the following code can be used: “the code for the fistulization of sclera for glaucoma, through the ciliary body is 0123T” (“2.07: Intro to CPT Coding” par. 47). Category III codes contain five characters: four digits plus some letters in the end.
Summing, the paper described each area, differentiated between them, and provided examples. The CPT categories of coding cover the needs of the healthcare industry in the correct codification of information, relevant to it. The procedures of coding are regulated by the American Medical Association (AMA).
2.07: Intro to CPT Coding 2016. Web.
AMA. CPT – Current Procedural Terminology. 2016. Web.
Bowie, Mary Jo. Understanding Current Procedural Terminology and HCPCS Coding Systems. New York, NY: Cengage Learning, 2016. Print.
Rouse, Margaret. “Current Procedural Terminology (CPT).” TechTarget. Web.
Sullivan, Laura. Introduction to CPT. 2011. Web.
UTHealth/McGovern Medical School. Current Procedural Technology: History, Structure, Process & Controversies. Web.