CPT® Category II Codes
Category II Code Section
(includes Release and Implementation dates)
Updated March 3, 2016
Category II Short Descriptor Changes/Additions
(There are no updates at this time)
Category II Medium Descriptors
(There are no updates at this time)
CPT Category II Codes Alphabetical Clinical Topics Listing
Updated February 12, 2016
An alphabetical listing of clinical conditions and topics with which the measures and codes are associated. It provides an overview of the performance measures, a listing of CPT Category II codes that may be used with each measure, as well as any applicable reporting instructions.
Instructions for submitting a CPT Category II Code proposal are found in CPT Category II Code Application.
The following list of Category II codes has been added to the Web site to allow a posting of the latest Category II codes developed. This listing of Category II codes is intended to identify those codes that have been added to the Category II coding set since the latest printing of the CPT® coding manual. Therefore, the codes noted within this listing will include only those codes that are not listed in the latest edition of the CPT coding manual. This listing should be appended to the codes included in the latest edition of the CPT coding manual.
The following section of Current Procedural Terminology (CPT®) contains a set of supplemental tracking codes that can be used for performance measurement. It is anticipated that the use of Category II codes for performance measurement will decrease the need for record abstraction and chart review, thereby minimizing administrative burden on physicians, other health care professionals, hospitals, and entities seeking to measure the quality of patient care. These codes are intended to facilitate data collection about the quality of care rendered by coding certain services and test results that support nationally established performance measures and that have an evidence base as contributing to quality patient care.
The use of these codes is optional. The codes are not required for correct coding and may not be used as a substitute for Category I codes.
These codes describe clinical components that may be typically included in evaluation and management services or other clinical services and, therefore, do not have a relative value associated with them. Category II codes may also describe results from clinical laboratory or radiology tests and other procedures, identified processes intended to address patient safety practices, or services reflecting compliance with state or federal law.
Category II codes described in this section make use of an alphabetical character as the 5th character in the string (i.e., 4 digits followed by the letter F). These digits are not intended to reflect the placement of the code in the regular (Category I) part of the CPT codebook. To promote understanding of these codes and their associated measures, users are referred to Appendix H, which contains information about performance measurement exclusion of modifiers, measures, and the measures' source(s).
|Diagnostic/screening processes or results||3006F-3573F|
|Therapeutic, preventive or other interventions||4000F-4306F|
|Follow-up or other outcomes||5005F-5100F|
Cross-references to the measures associated with each Category II code and their origins are included for reference in Appendix H. Users should review the complete measure(s) associated with each code prior to implementing its use.
Category II codes are reviewed by the Performance Measures Advisory Group (PMAG), an advisory body to the CPT Editorial Panel and the CPT/HCPAC Advisory Committee. The PMAG is comprised of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA) and the Physician Consortium for Performance Improvement. The PMAG may seek additional expertise and/or input from other national health care organizations, as necessary, for the development of Category II codes. These may include national medical specialty societies, other national health care professional associations, accrediting bodies and federal regulatory agencies.
CPT® is a registered trademark of the American Medical Association.