MeridianMERIDIAN

CPT Procedure Code

identity.medical.cpt

Current Procedural Terminology code for medical procedures and services. Format: 5 digits, or 4 digits followed by a letter suffix (F, T, or U for tracking/performance/services).

Casts to
VARCHAR

Shape

Pattern
^\d{5}$|^\d{4}[FTU]$
ValueLengthShape
992135matches
295805matches
2029F5matches
0307T5matches
992145matches
99214rejected: one character short

Background

Origin

The Current Procedural Terminology (CPT) code set is a procedural code set developed by the American Medical Association.[1] It is maintained by the CPT Editorial Panel.[1] It was designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organisations and payers.[1] The AMA holds the copyright for the CPT coding system.[1] Users of the CPT code set must pay licence fees to the AMA.[1]

Use

There are three types of CPT code: Category I, Category II and Category III.[1] Category II codes describe clinical components usually included in evaluation and management of clinical services.[1] Category II codes use an alphabetical character as the fifth character in the string.[1] Category III codes are a set of temporary codes for emerging technology, services, procedures and service paradigms.[2] Category III codes are differentiated from Category I codes by the use of alphanumeric characters: four digits followed by the letter T.[2] U of U Health Plans states that Category III codes will be retired if the procedure or service is not accepted as a Category I code within five years.[2] CMS lists Proprietary Laboratory Analysis (PLA) codes such as 0084U as CPT codes.[3] In its July 2019 laboratory fee schedule update, CMS names the laboratory and test alongside each new PLA code.[3]

Where you'll meet it

CMS publishes Medicare Physician Fee Schedule relative value files that hold relative value units and payment policy indicators for procedure codes.[4] CMS's notes on those files state that CPT codes and descriptions are copyright of the American Medical Association.[4] U of U Health Plans publishes a policy that lists Category III CPT codes, such as 0042T, by coverage status.[2] CMS's July 2019 laboratory fee schedule update lists new PLA codes, starting at 0084U, that Medicare Administrative Contractors may need to add to the HCPCS file by hand.[3]

Sources

  1. [1]Current Procedural Terminologysecondary source
  2. [2]U of Utah Health Plans - Medical, Admin, & Reimbursement Polciesorganisation
  3. [3]Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Paymentorganisation
  4. [4]Documentation and Filesorganisation

Detection notes

CPT codes maintained by the AMA. 5-digit numeric overlap with postal codes — disambiguation via header hints. Category II codes end in F, Category III codes end in T.

Use it

CLI · DuckDB
$ finetype infer -i "99213" --mode column
→ identity.medical.cpt

SELECT ft_infer('99213');
-- → 'identity.medical.cpt'
Cast expression
CAST({col} AS VARCHAR)

Schema

https://meridian.online/schemas/identity.medical.cpt · Frictionless type string

finetype taxonomy identity.medical.cpt -o json-schema

Aliases

procedure_code

Type Registry