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J Neurointerv Surg. 2015 Apr;7(4):309-12. doi: 10.1136/neurintsurg-2014-011156. Epub 2014 Mar 3.

Current procedural terminology; a primer.

Author information

1
Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
2
Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts USA.
3
Hackensack University Medical Center, Hackensack, New Jersey, USA.
4
Mecklenburg Radiology Associates P.A., Charlotte, North Carolina USA.
5
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
6
Norwich Diagnostic Imaging Associates, Norwich, Connecticut, USA.
7
Department of Progressive Radiology, The George Washington University, Falls Church, Virginia, USA.
8
Sierra Imaging Associates, Clovis, California, USA.
9
Pain Management Center of Paducah, Paducah, Kentucky, USA Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA.

Abstract

In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies developed an iterative coding system for describing medical procedures and services using uniform language, the Current Procedural Terminology (CPT) system. The current code set, CPT IV, forms the basis of reporting most of the services performed by healthcare providers, physicians and non-physicians as well as facilities allowing effective, reliable communication among physician and other providers, third parties and patients. This coding system and its maintenance has evolved significantly since its inception, and now goes well beyond its readily perceived role in reimbursement. Additional roles include administrative management, tracking new and investigational procedures, and evolving aspects of 'pay for performance'. The system also allows for local, regional and national utilization comparisons for medical education and research. Neurointerventional specialists use CPT category I codes regularly--for example, 36,215 for first-order cerebrovascular angiography, 36,216 for second-order vessels, and 37,184 for acute stroke treatment by mechanical means. Additionally, physicians add relevant modifiers to the CPT codes, such as '-26' to indicate 'professional charge only,' or '-59' to indicate a distinct procedural service performed on the same day.

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History

PMID:
24589819
DOI:
10.1136/neurintsurg-2014-011156
[Indexed for MEDLINE]

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