Exploring Medical Coding as a Career? Learn More About Common CPT Codes

If you’ve explored medical coding as a career, you’ve most likely heard about CPT codes. You might also have seen these codes on your own medical records and bills. CPT codes are a core part of medical coding. Learning more about them and seeing some examples of common codes used in the healthcare field can help you understand them better.

What Are CPT Codes?

Current Procedural Terminology codes, or CPT codes, are numeric codes used for medical services and procedures. A CPT Editorial Panel maintains CPT codes, which includes updating or modifying them as needed under the authorization of the American Medical Association (AMA). CPT codes typically have five digits, although some are made up of four digits and a letter.

The main use of CPT codes is for keeping track of healthcare services and procedures for billing purposes. Healthcare providers in doctor’s offices, outpatient clinics, hospitals, and other facilities list CPT codes on patient records and billing forms, then submit claims to the health insurance provider or payer. Insurers or payers use the listed CPT codes to determine the amount of money they will pay healthcare providers and the amount that patients owe.

Categories I, II, and III

Category I CPT codes are used the most in medical coding. These codes are used for healthcare services, procedures, medical devices, medications, and vaccines. Category I CPT codes are made up of five digits. Two-digit modifiers are sometimes used to give more details on services or procedures.

Category II CPT codes are used for quality of care and as performance measures. These codes are optional and are mainly used to give additional information or details, such as patient safety precautions, follow-up visits, behavioral therapies, or settings of delivered care. For example, a Category II code might indicate that a patient had heart failure assessed, which includes having their weight recorded, blood pressure measured, and other information. Category II CPT codes consist of four digits and the letter “F.”

Category III CPT codes are used for healthcare procedures and services that use emerging or experimental technology, services, or procedures. These are temporary codes that are made up of four digits and the letter “T.” Some of these codes eventually become Category I CPT codes. Those that don’t end up becoming a separate Category I CPT code receive an “unspecified procedure” code under Category I after being archived in the CPT manual for five years.

Category I Sections/Ranges

Category I CPT codes are grouped into different numerical ranges or fields. Each range or field contains subfields for specific healthcare fields. Category I numerical ranges include the following.

• Anesthesia: 00100 to 01999 and 99100 to 99140
• Surgery: 10021 to 69990
• Radiology: 70010 to 79999
• Pathology and Laboratory: 80047 to 89398
• Medicine: 90281 to 99199 and 99500 to 99607
• Evaluation and Management: 99201 to 99499

Common CPT Examples

Although there are more than 10,000 CPT codes overall, some are used more often. The following are examples of some of the most used CPT codes.

99213/99214 – General Office Visits

These are used for routine office visits, making them two of the top codes used in the CPT coding system. CPT code 99213 is used for low-complexity office visits, while 99214 is used for moderate-complexity office visits.

97110 – Therapeutic Exercises

This CPT code is used for therapeutic exercises in physical and occupational therapy settings to help patients improve their flexibility and strength. Examples include using a treadmill to build endurance or using lumbar stabilization to increase range of motion.

97112 – Neuromuscular Reeducation

This CPT code is used in physical and occupational therapy settings for exercises that are done to help restore body movement in patients with injuries or other conditions, such as stroke. Examples of these exercises include seated stability and isometric muscle contraction exercises.

99396 – Physical Checkup

This CPT code is used for physical checkups as part of preventive medicine in established patients between the ages of 40 and 64 years old. Also known as wellness visits, these checkups are part of routine preventive care.

99397 – Preventive Exam for Patient over 65

Similar to code 99396, this CPT code is used for physical checkups that are part of preventive medicine. However, this code is used for established patients who are 65 years old and up.

99386 – Preventive Exam for New Adult Patient

Different CPT codes are used for new patients who have preventive exams done. CPT code 99386 is used for adults between 40 and 64 years old who are new patients. Other codes are used for younger new patients having preventive exams done.

90658 – Administer Flu Shot

This code is used when a certain type of flu shot is administered. Specifically, this CPT code is used for the trivalent split virus flu vaccine given at 0.5 mL dosage intramuscularly. Different CPT codes are used for other flu shots, such as those given at different dosages, intranasal flu shots, and quadrivalent flu shots.

99283/99284/99285 – Emergency Department Visit

Emergency department visits have multiple CPT codes based on factors such as the type of problem a patient is experiencing. These CPT codes for emergency visits must meet three key components, which vary for each code. For example, code 99283 components include moderate-complexity decision-making, expanded problem-focused history, and expanded problem-focused examination.

36415 – Routine Venipuncture (Blood Draw)

This CPT code is used when a blood sample is taken from a vein for lab tests. A separate CPT code is used for a blood draw that is done from a capillary rather than a vein.

71045 – X-Ray Chest Exam 1 View

Different CPT codes are used for chest X-rays done in radiological settings. Code 71045 is used for chest X-rays done with a single view, while other codes are used for chest X-rays that are done with two or more views.

90999 – Dialysis Procedure

This CPT code is used for a dialysis procedure done in an inpatient or outpatient setting for end-stage renal disease. This includes both peritoneal dialysis and hemodialysis.

80053 – Comprehensive Metabolic Panel

This CPT code is used when a comprehensive metabolic panel is done to measure up to 14 substances in the blood, such as glucose, sodium, protein, and calcium. A separate CPT code is used for a basic metabolic panel that measures fewer substances.

93010 – Electrocardiogram Report

Electrocardiograms have different CPT codes based on factors such as whether they include tracing only or interpretation and report only. The number of leads used also determines the right code to use. CPT code 93010 is used for a routine electrocardiogram with 12 or more leads that provides interpretation and report only. Other codes are used for rhythm electrocardiograms with one to three leads.

99233 – Subsequent Hospital Care

This CPT code is used for follow-up hospital care in patients who are considered unstable or patients who present with significant complications. Other CPT codes for subsequent hospital care are used for patients who are considered stable or recovering and patients who have minor complications or are not responding well to treatment.

90837 – Psychotherapy with Individual Patient for 60 Minutes

CPT codes are also used for psychological or psychiatric services. CPT code 90837 is used for individual psychotherapy sessions that last for 60 minutes. Other CPT codes are used for individual psychotherapy sessions that last for shorter lengths of time, such as 30 minutes and 45 minutes. Different CPT codes are used for family psychotherapy and other types of mental health services.

Variation and Complexity of CPT Codes

While the CPT code examples given are among the most common, keep in mind that these are generalized or simplified. There are many more CPT codes used in the medical field for every type of service or procedure. Some of these CPT codes are used for highly specific services. Other CPT codes are newer ones that have been added due to changing circumstances in the healthcare field. For example, new codes were added within the past couple of years for the COVID-19 pandemic, including CPT codes for COVID vaccines.

Becoming a medical coder involves studying CPT codes and coding procedures in-depth in a diploma or degree program. These kinds of programs teach you the skills needed for medical coding, such as determining the right codes to use on billing forms and patient records. Having the right education can help ensure that you are prepared to take on the position of a medical coder and keep up with updates or changes to CPT codes.

Start Your Medical Coding Journey Today

If you want to build a career in medical coding, consider Bryant & Stratton College. We can provide you with information on our Medical Billing and Coding Diploma and our Medical Reimbursement and Coding Associate Degree program. Our associate degree program is offered online and at our campuses in New York, Virginia, and Wisconsin. Key courses in this program include CPT and HCPCS Level II Coding, Advanced CPT and HCPCS II Coding, and Professional Coder Practicum. Our diploma program is also offered online and at select campuses in New York, Wisconsin, and Virginia. Key courses in this program include CPT and HCPCS Level II Coding and Electronic Health Records.