Current Procedural Terminology (CPT) codes are used to identify medical services and procedures ordered by physicians or other licensed professionals.

In 1966, the American Medical Association (AMA) published the first edition of CPT codes.¹

In 1983, CPT was adopted as part of the Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS).¹

The Health Insurance Portability and Accountability Act (HIPAA) of 1996, made CPT and HCPCS as the national standards for electronic transaction of healthcare information.¹

CPT codes are vital for standardized medical procedure reporting and allows for healthcare utilization to be evaluated, medical guidelines to be developed and research to be generated.¹

HCPCS is a collection of standardized codes for medical procedures, supplies, products and services. HCPCS includes two levels of codes. Level I consists of CPT codes which are made up of 5 characters that are either all numbers or alphanumeric and managed by the American Medical Association. CPT codes are stratified into three types: Category 1, Category 2, Category 3 and Proprietary Laboratory Analyses (PLA). Category 1 covers procedures and Food and Drug Administration approved services.² This category contains five-digit numeric codes and is broken down into six sections:

• evaluation and management

• anesthesiology

• surgery

• radiology

• pathology and laboratory

• medicine²

Category 2 contains supplementary tracking codes that are used for performance measures and are intended to help collect information on the quality of care. The use of this medical code set is optional and is not a substitute for Category 1 codes. Category 3 consists of temporary codes that cover emerging technologies, services and procedures. They differ from the Category 1 medical CPT codes list in that they identify services that may not be widely performed by healthcare professionals, may not have FDA approval and also may not have proven clinical efficacy. To be eligible, the service or procedure must be involved in ongoing and planned research. The purpose of these CPT codes is to help researchers track emerging technologies and services. PLA codes are alpha-numeric CPT codes used for lab testing.² 

There are more than 10,000 CPT codes and for 2021 there are a total of 329 CPT code changes: 206 code additions, 54 code deletions, and 69 code revisions.^3,4

The six most commonly used CPT codes are for: new patient office visits, established patient office visits, initial hospital care for new or established patients, subsequent hospital care, emergency department visits and office consultations.²

1. Dotson P. CPT® Codes: What Are They, Why Are They Necessary, and How Are They Developed?. Adv Wound Care (New Rochelle). 2013;2(10):583-587. doi:10.1089/wound.2013.0483

2. Lee K. Current Procedural Terminology (CPT) code. TechTarget. https://searchhealthit.techtarget.com/definition/Current-Procedural-Terminology-CPT. Published 2015. 

3. CPT® codes, then and now. CPT. 2015. https://www.ama-assn.org/practice-management/cpt/cpt-codes-then-and-now. 

4. Poland L. Highlights of the 2021 CPT Code Updates. Journal of the American Health Information Management Association. https://journal.ahima.org/highlights-of-the-2021-cpt-code-updates/. Published 2021.