AMA CPT® Assistant - 2019 Issue 3 (March)
The CPT Code Process: An Overview (March 2019)
March 2019 pages 3-4 The CPT Code Process: An Overview As a reader of the CPT® Assistant newsletter, you are a first-line stakeholder who helps ensure the Current Procedural Terminology (CPT®) code set is properly utilized throughout the healthcare system. However, it may not be easy to understand how a CPT code is created. Over the more than 50 years since the code set's inception, the American Medical Association (AMA) and the CPT Editorial Panel (the Panel) have implemented many improvements and innovations to ensure that the code set remains adaptable to meet the growing demands of an...
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Article Overview
This article explains the CPT code review and application process and describes recent updates to CPT submission requirements and review workflows. It is aimed at stakeholders involved in coding, medical specialty societies, providers, payers, and other interested parties who want to understand how CPT proposals are handled and how review criteria and deadlines are structured. The discussion covers the roles of AMA staff, the CPT Editorial Panel, advisory participants, standing advisory groups, and the general types of guidance used in evaluating code-change applications.
Why This Topic Matters
Understanding the CPT review process helps stakeholders prepare more complete submissions and follow how proposed code changes move through review and decision steps. It is relevant for organizations and professionals who participate in CPT development or need to track procedural updates affecting code set maintenance.
Article Sections
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March 2019 pages 3-4
Publication and page reference for the article content.
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The CPT Editorial Panel
Describes the structure, membership, and supporting organizations involved in CPT review activities.
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CPT Code: Categories and Criteria
Summarizes the general categories of CPT coding review criteria and the broad differences among code categories.
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CCA Process Submission
Outlines who may submit code-change applications and the broad submission requirements and compliance steps involved.
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Innovations and Improvements
Reviews recent updates intended to align the application process with evolving stakeholder and clinical reporting needs.
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Updating Literature Requirements for Category I Codes
Covers revisions related to literature review expectations used in application evaluation.
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Proprietary Laboratory Analyses Code Set
Discusses process changes related to a laboratory-focused CPT code subset and its quarterly review cycle.
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Timelines and Deadlines
Explains the schedule for application review, comment compilation, and Panel consideration.
What You Will Learn
- How the CPT code review process is organized
- Which organizations and advisory groups participate in CPT review
- What broad criteria are considered for code-change applications
- How stakeholders submit CPT code-change applications
- What process updates were highlighted for literature review and laboratory analyses
- How CPT review timelines and deadlines are structured
Who Should Read This
- Medical coders
- Coding managers
- Physicians
- Hospitals
- Medical specialty societies
- Payers
- Health information management professionals
- Other CPT stakeholders
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