CPT Code
Also known as: Procedure Code, Billing Code
A standardized code used to describe medical procedures and services for billing purposes.
Full Definition
CPT (Current Procedural Terminology) codes are maintained by the AMA and used by providers to bill insurers for procedures and services. A new medical technology typically requires either an existing CPT code that can be used for billing or a new CPT code established through the AMA CPT Editorial Panel process. Category I codes reflect established procedures. Category III codes are temporary codes for emerging technologies that may eventually transition to Category I with sufficient evidence.
Example
A new endoscopic procedure uses an existing Category I CPT code because it is a modification of an established technique. A novel AI diagnostic service applies for a Category III code through the AMA process while building the clinical evidence needed for a Category I code.