CPT - Current Procedural Terminology
The CPT Editorial Panel is engaged in an ongoing process improvement effort which currently includes re-examination of the CPT Category I and Category III criteria. Based on these efforts periodic changes to this website should be expected. Please be sure to contact CPT staff if you have any questions.
CPT® RUC Schedule
Calendar for the CPT Editorial Panel process and the AMA-Specialty Society RVS Update process.
Notice of CPT Editorial Panel Planning Session Regarding New Section of CPT Related to PAMA
You are invited to a telephone meeting sponsored by the CPT Editorial Panel on Tuesday, December 15, 2015, from 7 p.m. to 9 p.m. CST for input from all interested stakeholders about the new CPT clinical laboratory test section. Topics to be covered include (a) relevant background of the PAMA proposed rule; (b) the CPT Editorial Panel’s initial response to create the new section in CPT and potential plans for implementation; and (c) the opportunity for stakeholders to provide comments and recommendations for the CPT Editorial Panel to consider. This will be a planning session for the CPT Editorial Panel and not a formal Panel meeting for consideration of a code change proposal. Instead, this meeting will help guide the CPT Editorial Panel and CPT staff in generating the code change proposal to be considered by the Panel at a future public meeting and the already-planned February CPT Editorial Panel meeting. The AMA encourages all interested stakeholders to engage in the discussion to help achieve a consensus-driven coding solution that meets the needs of a broad cross section of stakeholders.
If you wish to participate, please email email@example.com as soon as possible. You will need to complete a Confidentiality and Copyright Assignment form and return it no later than December 8, 2015. Please email or fax (312-224-6916) the form to Judy. After this date, we will be unable to add you to the security list for access to the call.
CPT Editorial Panel Authorizes the Establishment of a New Clinical Laboratory Test Section
The Protecting Access to Medicare Act of 2014 (PAMA) mandates the creation of specific HCPCS codes for Advanced Diagnostic Laboratory Tests (ADLTs) and Clinical Diagnostic Laboratory Tests (CDLTs) that are cleared or approved by the Food and Drug Administration (FDA). Over the past year, the Molecular Pathology Coding Workgroup (MPCW) of the CPT Editorial Panel (Panel) has hosted public meetings with stakeholders to discuss potential CPT coding solutions that could meet the statutory coding requirements in PAMA.
On September 25, 2015, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of G codes to identify new and existing ADLTs and new and existing CDLTs (that are not ADLTs) that are cleared or approved by the FDA if a specific HCPCS code does not already exist. In addition, the proposed rule provides that use of the existing HCPCS system—comprised of CMS HCPCS Level II codes and HCPCS Level I CPT codes—does not require additional unique identifiers. Further, the Agency proposes to expressly prohibit the use of unlisted and Not Otherwise Classified (NOC) codes for purposes of reporting private payer rates under PAMA. As noted by the CMS, G codes are temporary HCPCS Level II codes used by CMS to identify professional health care procedures and services, including laboratory tests that would otherwise be identified by a CPT code, but for which there is no CPT code.
In early October, the MPCW held a public meeting during the regularly scheduled Panel meeting in order to solicit additional input and feedback on an appropriate coding solution that would ensure consistent and accurate coding for all stakeholders including payers, providers, and clearinghouses. In early November, the Panel authorized the establishment of a new section in the CPT code set. The new section established by the Panel provides an infrastructure whereby a clinical laboratory or manufacturer that meets certain criteria may request a code to more specifically identify their test. This section is separate from the Category I Pathology and Laboratory section and will include ADLTs and CDLTs as defined under PAMA. The clinical laboratory or manufacturer that offers the test must request the code.
It is envisioned that the codes in this new section will be issued on a quarterly basis and effective the following quarter to allow payers time to load them into their systems. The Panel would be responsible for verification of the information submitted and codification of tests in this section. The Panel will not determine whether or not the test meets the criteria of an ADLT, which will be determined by CMS.
This new section provides a sustainable coding infrastructure utilizing an established, transparent process that will ensure consistent national coding across Medicare and other public and private payers. This solution represents the longstanding commitment of the Panel to ensure the CPT code set provides a uniform language and meets the needs of a broad cross-section of stakeholders.
Telehealth Services Workgroup
The AMA is pleased to announce the formation of a CPT® Telehealth Services Workgroup, which will be chaired by members of the CPT Editorial Panel. The workgroup will be comprised of relevant medical specialties/organizations and industry stakeholders. The workgroup will recommend additions and changes to the CPT code set related to medical services utilizing telehealth technology. The charge of this ad-hoc workgroup is to:
- Recommend solutions for the reporting of current non-telehealth services when using remote telehealth technology (to include but not limited to E/M services). Considerations will include potential new codes, use of current codes without or with modifier, add-on code(s).
- Address the accuracy of current code set in describing the services provided when telehealth data is reviewed and analyzed, including potential code set revisions and/or education for:
- Appropriate code use (e.g., E/M versus data analysis codes);
- Potential code development to report analysis of transmitted data;
- Definition of data types whose interpretation will require differentiation and consideration of separate reporting of current E/M services/codes
- Potential new E/M services codes based on emerging new patterns for sites of service.
- Recommend whether any other telehealth service codes should be developed based upon services currently being provided.
- Develop new introductory language or modify existing introductory language to guide coding of telehealth services.
The workgroup will also help facilitate discussions with key stakeholders who may wish to bring forward telehealth services applications for consideration. According to the CPT Editorial Panel AdHoc Workgroup Organizational Structure and Processes guidance, all workgroup recommendations will be presented in a Code Change Application(s) for consideration by the CPT Editorial Panel. Participation in the Telehealth Services Workgroup does not preclude the submission of a separately developed code change application for consideration by the Editorial Panel.
If you are interested in participating in the CPT Telehealth Services Workgroup, please submit a written statement that provides your rationale for participation in this workgroup and a brief description of your particular expertise that would ensure the success of the workgroup. Please submit your written response with the relevant information by September 4, 2015, to firstname.lastname@example.org by return email.
If selected, you will be notified via email by AMA staff of upcoming Telehealth Services Workgroup meetings, which will include one or more teleconference meetings among workgroup members (specific dates to be determined). In addition, a face-to-face meeting will be held in Philadelphia, PA during the October 2015 CPT Editorial Panel meeting.
The workgroup seeks input from individuals who can provide the technical expertise regarding telehealth services to assure the ongoing relevance of the CPT code set. Participation in this workgroup is limited to parties with demonstrated expertise relevant to current telehealth technology and the clinical procedural aspects of telehealth services/procedures. Participants are expected to perform or represent those who perform the services under consideration by the workgroup and have the expertise and interest necessary to contribute to the workgroup. Participation is intended to provide expertise relating to general categories of telehealth and not to advance the proprietary interests of specific parties. As such, preference will be granted to professional and trade organizations that reflect a category of telehealth services rather than a single product. Applicants will be notified of the composition of the Telehealth Services Workgroup during the week of September 14-18.View some background information on Telehealth Services.
CPT Editorial Panel Meeting
Registration for hotel accommodations is now open for the CPT Editorial Panel Meeting which will be held at the Hyatt Regency, Miami, FL 33131 on February 4-6, 2016.
- Registration for the CPT Editorial Panel and CPT-HCPAC Annual meetings should be available December 1, 2015.
- Hotel Reservation at Hyatt Regency Miami
The Hyatt Regency is almost totally booked for the time of our meeting. If you are unable to secure a room at the Hyatt, you may try one of the following hotels close to the Hyatt Regency.
(across the street from Hyatt)
|200 SE 2nd Ave.
Miami, FL 33131
(across the street from Hyatt)
|270 Biscayne Boulevard Way
Miami, FL 33131
|JW Marriott Marquis
(across the street from the Hyatt)
|255 Biscayne Boulevard Way
Miami, FL 33131
(6 blocks from Hyatt)
|1109 Brickell Avenue
Miami, FL 33131
(8 blocks from the Hyatt)
|1395 Brickell Avenue
Miami, FL 33131
Scheduling Discussion of Agenda Items
Sometimes requests are received for the Panel to plan discussion of an item of business in order to accommodate the schedule of presenters. While we try to work with the needs of those participating in the meeting, we are unable to guarantee when an item of business will be brought before the Panel. To ensure that the agenda flows smoothly, presenters should plan to be present for the entire meeting schedule.
The Calendar of Upcoming CPT Editorial Panel meetings shows the meeting dates through September,2017, locations, and other dates pertinent to each meeting.
Important Dates and Deadlines for the Upcoming CPT Editorial Panel Meeting:
|Dates of the upcoming CPT Editorial Panel Meeting||February 4-6, 2016
|Location of upcoming CPT Editorial Panel Meeting||Hyatt Regency Miami
|Deadline for Submitting Coding Change Applications||November 4, 2015|
|Deadline for posting the meeting agenda to the public AMA/CPT website||December 4, 2015|
|Online Registration opens for Editorial Panel Meeting||December 1, 2015|
|Online Registration opens for Hotel Lodging||November 15, 2015|
|Deadline for Submitting Coding Change applications for February, 2016 CPT Editorial Panel Meeting||November 4, 2015|
Molecular Pathology Coding Workgroup (MPCW)
Slides from the October, 2015, meeting of the MPCW are available.
Quantitative Drug Testing Workgroup (QDTW)
The Quantitative Drug Testing Workgroup Notice contains the new, revised and deleted codes in the Drug Testing, Therapeutic Drug Assay, and Chemistry sections. These codes will be effective January 1, 2015.
CPT® Process - How a Code Becomes a Code
Did you ever wonder how CPT codes are created and how the code set is maintained? This section provides a brief overview and history of CPT, the process of code request submission and review, and the roles that the Panel and Advisory Committee groups have in the process.
CPT® Process Rules
The CPT Process Rules documents are provided for reference for those individuals participating in the CPT Editorial or Workgroup processes to provide an understanding of the standards and expectations in place to ensure the integrity and quality of the CPT Code process and the resulting CPT code set.
These are the current versions of the CPT Process Rules Documents. The CPT Editorial Panel is engaged in an ongoing process improvement effort which currently includes re-examination of the CPT Category I and Category III criteria. Based on these efforts periodic changes to this website should be expected. Please be sure to contact CPT staff if you have any questions.
- CPT Editorial Panel AdHoc Workgroup Organizational Structure and Processes
- Review of CPT Editorial Panel Actions - Requests for Reconsideration
- Application FAQ's
- Statement on Lobbying
- CPT Editorial Panel Conflict of Interest Policy
- CPT Editorial Panel Confidentiality Agreement for Attendance at Meetings
- Guidelines for Medical Specialty Societies' Coding and Nomenclature Committees
- Guidance for CPT HCPAC Advisors
Preparing, Reviewing and Commenting on Applications, Educating your Society and Coordinating with your Society's RUC Advisors
Sign up to receive email notification when changes are posted to the AMA website for CPT Announcements, Category II codes, Category III codes, Vaccine codes, Errata and Panel Agenda Proposals and Subsequent Actions. You may also receive notice when registration opens for the CPT Editorial Panel meeting.
The CPT® Network is an internet-based system that provides members and subscribers the tools to quickly research a database of commonly asked questions and clinical examples (vignettes). If the answer to a specific question cannot be found in the database, authorized users will have the capability to submit an electronic inquiry using a standardized form directly to the staff of CPT coding experts.
CPT® products and services
Information on AMA's CPT Products and Services. Downloadable copies of the CPT, ICD-9-CM and HCPCS files are available for purchase.
The AMA is committed to making CPT widely available at low cost. The AMA holds copyright on CPT and use or reprinting of CPT in any product or publication requires a license. License applications are available here.
HCPCS - Special announcements and reports
ICD-9-CM 2009 product updates and errata
Post-publication updates for the ICD-9-CM products shows the code application names, code(s) affected, and a description of the request. During the time period between now and the Panel meeting, the agenda will, most likely, be modified to reflect changes – additions, deletions or updates. Please check back frequently for the most up to date information.