CPT (Current Procedural Terminology) is the American Medical Association's code set for reporting medical, surgical and diagnostic procedures and services. In drug billing, CPT describes the service — giving an injection or infusion — while the drug itself is usually reported with a HCPCS Level II code.
Three categories
Category I codes are five-digit codes for established procedures and services. Category II codes (four digits and an F) are optional tracking codes for performance measurement. Category III codes (four digits and a T) are temporary codes for emerging technology.
Where CPT meets drugs
When a clinician administers a drug, the administration is a service reported with a CPT code from the drug administration section — hydration, therapeutic injections and infusions, and chemotherapy or other highly complex drug administration. Which code applies depends on route, duration and the type of drug.
Vaccines are the main exception on the product side: the vaccine itself has a CPT product code in the 90476–90759 range, reported with a separate immunization administration code.
What Med-Code publishes about CPT
CPT is copyrighted by the AMA and its descriptors are licensed. Med-Code does not reproduce CPT descriptor text. It explains how CPT relates to drug billing, lists CPT vaccine product codes for the vaccines in its directory with its own product-level descriptions, and points to the drug administration code families that apply to a product's route.
For full CPT descriptors and guidelines, use the AMA's CPT publications or a licensed coding product.
Questions
Does Med-Code have a CPT code lookup?
Not for descriptors. Med-Code does not hold a CPT licence, so it does not publish CPT descriptor text. It covers how CPT codes relate to drugs and vaccines.
Is a CPT code the same as a HCPCS code?
CPT is HCPCS Level I. HCPCS Level II is a separate code set maintained by CMS that covers drugs, supplies and services not in CPT.