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Describing CPT Coding Categories

There are three types of codes each person should be proficient in using. They are labeled by category, contain five digits, and can be confusing. For Category I it is easy to remember as this category will not contain an alphabetic letter in the code. This category’s codes are used for standard services and usually will contain a descriptor or short description of the procedure or reason for service. An example of this would be a routine office for an annual physical. This would be coded as 12345 with a descriptor of “routine annual physical”. This allows for an easy reference for insurance companies and all healthcare professionals. Category II coding is used for tracking the progress of treatments. These treatments are for things like tobacco or drug addiction recovery and are not usually covered by insurance. An easy way to recognize this code is by the payment.

A good slogan is “With Category II there is a payment due”. These codes will have five digits but the last digit will be alphabetical digit. An example of this is a 30 year old male in counseling for alcohol addiction. The code would be 2345A. When this code appears, just look to see if it is covered by insurance and you will recognize it immediately. Category III is only used when the procedure and technology are new or emerging. An example would be a new therapy used following orthopedic surgery. It also has five digits with the last digit alphabetical. A slogan for this would be “Category three is only temporary”. Be w

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