CPT (CPT Codes)
A standardized five-digit medical code set maintained by the AMA that describes services and procedures for healthcare billing.
Key Facts
- Current Procedural Terminology — maintained by the American Medical Association (AMA)
- Five-digit codes that describe medical, surgical, and diagnostic services for billing
- Required by most U.S. payers (commercial, Medicare, workers' comp) for claim adjudication
- Updated annually; effective January 1 each year
- Common occ-med examples: 99202–99215 (E/M), 94010 (spirometry), 92551 (audiogram), 80305 (drug screen, presumptive)
Current Procedural Terminology (CPT) is the code set maintained by the American Medical Association (AMA) used to report medical, surgical, and diagnostic services on healthcare claims. CPT codes are five-digit numeric (with select alphanumeric Category II and III codes) and are required by virtually every U.S. payer — commercial insurers, Medicare, Medicaid, and workers' compensation carriers — to adjudicate claims. The AMA publishes annual updates each fall that take effect January 1. For occupational-health clinics, fluency in the relevant CPT subsets is essential to revenue capture: evaluation and management codes (99202–99215 for new and established office visits), spirometry (94010, 94060), audiometry (92551 screening, 92552 threshold), respirator fit-testing (no dedicated CPT — typically billed as an E/M or with HCPCS), drug screening (80305 presumptive, 80306 with read-by-instrument, 80307 confirmatory), venipuncture (36415), and immunization administration (90460–90474). Many occ-med encounters are billed direct-to-employer (cash) rather than through insurance, but CPT coding remains the lingua franca for charge masters, audits, and any payer-facing work.
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