Category II CPT Coding
Category II CPT codes are supplemental tracking codes used to measure performance. It is anticipated that the use of these codes will decrease the need for record abstraction and chart review and thereby minimize the administrative burden on providers, and any other entity interested in measuring the quality of patient care. They are intended to facilitate data collection about the quality of care rendered by coding certain services and test results that support nationally established performance measures and that have an evidence base as contributing to quality patient care.
The use of these codes is optional. The codes are not required for correct coding and may not be used as a substitute for Category I codes.
These codes describe clinical components that may be typically included in evaluation and management services or clinical services and, therefore, do not have a relative value associated with them. Category II codes may also describe results from clinical laboratory or radiology tests and other procedures, identified processes intended to address patient safety practices, or services reflecting compliance with state or federal law.
Category II codes described in this section make use of alphabetical characters as the 5th character in the string (ie, 4 digits followed by the letter F). These digits are not intended to reflect the placement of the code in the regular (Category I) part of CPT. When you determine the need to implement the use of these codes and their associated measures, users are referred to appropriate information about performance measurement exclusion modifiers, measures source.
Using the letter “F”: the Physical Examination (number=2000) is written 2000F
Category II codes are reviewed by the Performance Measures Advisory Group (PMAG), an advisory body to the CPT Editorial Panel and the CPT/HCPAC Advisory Committee. The PMAG is comprised of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA), and the Physician Consortium for Performance Improvement. The PMAG may seek additional expertise and/or input from other national health care organizations, as necessary, for the development of tracking codes. These may include national medical specialty societies, other national health care professional associations, accrediting bodies, and federal regulatory agencies.
Category II codes are published biannually: January 1 and July 1. The most current listing, along with guidelines and forms for submitting code change proposals for Category II codes, may be accessed on the Internet at https://www.ama-assn.org/go/cpt.
- (For blood pressure measured, use 2000F)
- (0002F has been deleted. To report, use 1000F)
- (0003F has been deleted. To report, use 1001F)
- (0004F has been deleted. To report, use 4000F)
- (For tobacco use cessation intervention, pharmacologic therapy, use 4001F)
- (0006F has been deleted. To report, use 4002F)
- (0007F has been deleted. To report, use 4006F)
- (0008F has been deleted. To report, use 4009F)
- (0009F has been deleted. To report, use 1002F)
- (0010F has been deleted)
- (0011F has been deleted. To report, use 4011F)
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