CPT Category II Performance Measurement-Submitting a Code Change Proposal (July 2002)

July 2002 page 5-end Coding Update: CPT Category II Performance Measurement-Submitting a Code Change Proposal This article serves as an update on the latest recommendations from the Performance Measurement Advisory Committee (PMAG) and the CPT Editorial Panel regarding the development of Category II codes. Additionally, it includes information that lists the criteria for creation of a Category II code, as well as the application necessary for submitting a code proposal for inclusion as a Category II code. Finally, language that will be inserted as part of the introduction section of CPT 2004 has been included to identify the intended...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains the background, purpose, and administrative framework for CPT Category II performance measurement codes. It outlines the organizations involved, the criteria used to evaluate proposals, and the structure of the code change proposal form used for submission. The piece is aimed at coding professionals, quality reporting stakeholders, specialty societies, and organizations preparing performance-measurement proposals. It is most relevant to readers seeking to understand the general process and documentation expectations for Category II code development.

Why This Topic Matters

It provides the public-facing guidance needed to prepare and route Category II code proposals and to understand how performance measurement tracking codes fit into the CPT system and quality-reporting workflow.

Article Sections

  1. July 2002 page 5-end

    A brief coding update and overview of the article’s scope and purpose.

  2. The Performance Measures Advisory Committee (PMAG) and Intended Use of the Category II Codes

    Background on the advisory committee, the development process for Category II codes, and the intended role of the code category within performance measurement.

  3. Background

    General context for the category, including how the code set is positioned within CPT and the types of reporting it is meant to support.

  4. Instructions for Submission of Category II Code Proposals

    Overview of who may submit proposals and the broad documentation expectations for requests reviewed through the process.

  5. Criteria for Submitting CPT Category II Code Proposals

    A summary of the proposal criteria and the major characteristics expected of a performance-measure tracking code request.

  6. CPT Category II Code Change Proposal

    Introduction to the proposal form used for code change submissions and the administrative details required to complete it.

  7. Instructions for Completing this Form

    Field-by-field guidance for completing the submission form and the organizational contact information needed for routing.

What You Will Learn

  • The role of CPT Category II codes in performance measurement
  • How the PMAG and CPT Editorial Panel are involved in proposal review
  • What broad types of information are requested in a Category II code proposal
  • How the Category II code change proposal form is structured
  • Which organizations and stakeholders participate in the review process

Who Should Read This

  • Medical coders
  • Coding educators
  • Quality reporting professionals
  • Physician practices
  • Specialty societies
  • Healthcare organizations preparing code proposals

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