Physicians' Current Procedural Terminology (CPT)
Physicians' Current Procedural Terminology , Fourth Edition (CPT) is a listing of descriptive terms and identifying codes for reporting medical services and procedures. The purpose of the terminology is to provide a uniform languages that will accurately describe medical, surgical and diagnostic services, and will thereby provide an effective means for reliable nationwide communication among health professionals, patients and third-parties. The first edition of CPT appeared in 1966.
CPT was created and is authored by the American Medical Association (AMA).
The AMA is a member of ANSI. CPT is copyrighted by the AMA.
Physicians' Current Procedural Terminology, Fourth Edition (CPT)
CPT contains the American Medical Association's listing of descriptive terms and identifying codes. It also contains numeric modifiers, notes, guidelines and an index designed to provide explanatory information and facilitate the correct usage of the coding system.
Contact For More Information
Celeste G. Kirschner
Director, Coding and Nomenclature
American Medical Association
515 N. State Street
Chicago, IL 60610
Indicator of Market Acceptance
CPT is used as the reporting mechanism by physicians and many other health professionals in the United States. It is the coding system used by Medicare and virtually all third party payors, including workers compensation and Medicaid. Hospitals use CPT codes to report outpatient service to Medicare. Its usage internationally is growing, particularly by United States companies that have international components. CPT was recently selected as the coding system of choice by the Medical Association of South Africa. CPT is Level I of HCPCS (HCFA Common Procedure Coding System).
Level of Specificity
CPT contains over 7300 codes to describe medical and surgical procedures. CPT is divided into 6 major sections, including Evaluation and Management Services, Anesthesia, Surgery, Radiology, Pathology and Medicine. The section heads, subheads, and titles provide an implicit hierarchy. The Surgery section is subdivided anatomically. The Medicine Section is divided by medical subspecialties. A series of two digit modifiers are also included to make the coding system more specific, to allow the reporting of a procedure under specific circumstances. For example, modifiers may be used to describe the use of assistant surgeons, a bilateral procedure, or a return to the operating room during the postoperative period.
Maintenance of CPT
CPT is authored by the American Medical Association. The CPT Editorial Panel is made up of 15 physicians, 10 nominated by the AMA and one each nominated by the Blue Cross and Blue Shield Association, the Health Insurance Association of America, the Health Care Financing Administration and the American Hospital Association. A non-physician representative of the Health Care Professionals Advisory Committee (HCPAC) also serves as a member of the Panel.
The Panel's Executive Committee includes the chairman, the vice chairman and three other members of the Panel, as elected by the entire Panel. One of the three members-at-large of the executive committee must be a third-party payer representative. The AMA provides staff support for the CPT Editorial Panel and appoints a staff secretary.
Supporting the Editorial Panel in its work is the CPT Advisory Committee. Committee members are primarily physicians nominated by the national medical specialty societies represented in the AMA House of Delegates. The Health Care Professional Advisory Committee allows for participation of organizations representing limited license practitioners and allied health professionals. Most members of the Advisory Committee serve as Chair of a specialty society committee and thus form a network of approximately 1000 physicians and other health professionals actively working to maintain the clinical integrity of the system.
Current Procedural Terminology (CPT) is available in the following print and electronic formats:
1 volume spiral-bound edition;
1 volume soft bound edition;
1 volume spiral-bound Professional edition;
1 volume three-ring bound Professional edition
Electronic versions in EBCDIC or ASCII for full and short description magnetic tape formats; also available in diskette format, short or long description which can be used with any software that allows import of an ASCII file. A CD-ROM version, that includes CPT, is available for 1997.
In addition, CPT is currently licensed to many software system vendors and publishing companies.
CPT is available at low cost through the AMA or through the AMA's licensing activities. CPT can be purchased from the AMA in print formats for as low as $38. CPT can be licensed from the AMA in electronic formats for as low as $149. Licenses are granted to those that distribute CPT in print and electronic formats. Licenses for CPT in print products are granted for as low as $10 per product. Licenses for CPT in electronic products are granted for $50 per product license with a minimal additional user fee for multi-user versions. The codes are revised yearly.