ASSIGNMENT-1

OF
HEALTHCARE DATA ANALYTICS

SUBMITTED TO: Dr AVANI VYAS

SUBMITTED BY: Rahul Manoj Paka
MTECH (DA) 2nd SEM
23201803
 Categories of CPT coding
Common Procedural Terminology (CPT) coding is a system used to standardize the reporting of
medical, surgical, and diagnostic procedures and services in healthcare. CPT codes are developed
and maintained by the American Medical Association (AMA). These codes are categorized into three
main categories:

Category I CPT Codes: These codes are the most frequently used and represent a wide
range of procedures and services, including medical evaluations, surgical procedures, diagnostic
tests, and various other medical services. Category I codes are five-digit numeric codes, and they are
further subdivided into six sections:

a. Evaluation and Management (E/M) Services:- Evaluation and Management (E/M) Services are
one of the primary categories of CPT codes, encompassing a wide range of medical services related
to patient assessment, examination, diagnosis, and management. These codes are used to report the
time and expertise of healthcare professionals, such as physicians, nurse practitioners, and physician
assistants, involved in the evaluation and management of patients.

b. Anesthesia Services:- Anesthesia Services is another important category within the Common
Procedural Terminology (CPT) coding system, specifically dedicated to the reporting of anesthesia
procedures provided to patients undergoing surgical or diagnostic procedures. Anesthesia is
administered to ensure patient comfort, pain control, and safety during medical procedures, and the
Anesthesia Services category includes a wide range of services related to anesthesia administration
and management.

c. Surgery Services:- Surgery Services is a fundamental category within the Common Procedural
Terminology (CPT) coding system, encompassing a wide range of surgical procedures performed by
healthcare professionals such as surgeons, surgical assistants, and other qualified personnel. These
codes are used to report surgical interventions across various medical specialties and subspecialties.

d. Radiology Services:- Radiology Services represent a vital category within the Common Procedural
Terminology (CPT) coding system, covering a broad range of diagnostic and interventional
procedures involving medical imaging technologies. These procedures are performed by radiologists,
radiologic technologists, and other qualified healthcare professionals to diagnose and treat various
medical conditions across different specialties.

e. Pathology and Laboratory Services:-

Pathology and Laboratory Services constitute a significant category within the Common Procedural
Terminology (CPT) coding system, encompassing a wide range of diagnostic tests, procedures, and
analyses performed on various types of specimens (such as blood, urine, tissue samples, and body
fluids) to aid in the diagnosis, monitoring, and treatment of diseases and conditions.
f. Medicine Services:- Medicine Services is a significant category within the Common Procedural
Terminology (CPT) coding system, covering a wide range of medical procedures and services that do
not fall under other specific categories such as surgery, radiology, pathology, or anesthesia. The
Medicine Services category includes codes for various non-surgical, non-diagnostic, and non-
laboratory medical services provided by healthcare professionals across different specialties.

Category II CPT Codes: These codes are optional and are used to track performance
measures. They are alphanumeric and consist of four digits followed by the letter "F." Category II
codes are intended to facilitate data collection related to quality of care, patient safety, and
outcomes. They are not used for billing purposes but rather for performance measurement and
quality improvement activities.

Category III CPT Codes: Also known as temporary codes, these codes are used for
emerging technologies, services, and procedures. They allow data collection for new procedures or
services for which there may not yet be enough data to justify the assignment of a Category I code.
Category III codes are five-digit numeric codes followed by the letter "T."

In addition to these three main categories, there are also modifiers that can be appended to CPT
codes to provide additional information about the service or procedure performed. Modifiers may
indicate that a service was modified in some way, performed by more than one physician, or
provided in a unique circumstance, among other things. These modifiers help to clarify the details of
the service provided and ensure accurate billing and reimbursement.