# CPT Procedure Code Key: `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). Page: Samples: `99213`, `29580`, `2029F`, `0307T`, `99214` ## Background ### Origin The Current Procedural Terminology (CPT) code set is a procedural code set developed by the American Medical Association.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) It is maintained by the CPT Editorial Panel.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) It was designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organisations and payers.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) The AMA holds the copyright for the CPT coding system.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) Users of the CPT code set must pay licence fees to the AMA.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) ### Use There are three types of CPT code: Category I, Category II and Category III.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) Category II codes describe clinical components usually included in evaluation and management of clinical services.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) Category II codes use an alphabetical character as the fifth character in the string.[[1]](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) Category III codes are a set of temporary codes for emerging technology, services, procedures and service paradigms.[[2]](https://doc.uhealthplan.utah.edu/medicalpolicy/admin-015.pdf) Category III codes are differentiated from Category I codes by the use of alphanumeric characters: four digits followed by the letter T.[[2]](https://doc.uhealthplan.utah.edu/medicalpolicy/admin-015.pdf) 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]](https://doc.uhealthplan.utah.edu/medicalpolicy/admin-015.pdf) CMS lists Proprietary Laboratory Analysis (PLA) codes such as 0084U as CPT codes.[[3]](https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2019downloads/r4326cp.pdf) In its July 2019 laboratory fee schedule update, CMS names the laboratory and test alongside each new PLA code.[[3]](https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2019downloads/r4326cp.pdf) ### 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]](https://www.cms.gov/medicare/physician-fee-schedule/search/documentation) CMS's notes on those files state that CPT codes and descriptions are copyright of the American Medical Association.[[4]](https://www.cms.gov/medicare/physician-fee-schedule/search/documentation) U of U Health Plans publishes a policy that lists Category III CPT codes, such as 0042T, by coverage status.[[2]](https://doc.uhealthplan.utah.edu/medicalpolicy/admin-015.pdf) 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]](https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2019downloads/r4326cp.pdf) ## Sources 1. [Current Procedural Terminology](https://en.wikipedia.org/wiki/Current_Procedural_Terminology) — secondary source 2. [U of Utah Health Plans - Medical, Admin, \& Reimbursement Polcies](https://doc.uhealthplan.utah.edu/medicalpolicy/admin-015.pdf) — organisation 3. [Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment](https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2019downloads/r4326cp.pdf) — organisation 4. [Documentation and Files](https://www.cms.gov/medicare/physician-fee-schedule/search/documentation) — organisation