What are CPT codes used for?

• A. To report diagnoses
• B. To report procedures/services performed by physicians and other qualified professionals
• C. To report HCPCS Level II non-physician services
• D. To code patient demographics

Answer: (B)

At the heart of CPT coding is describing the procedures and services performed by physicians and other qualified professionals for billing purposes. This set standardizes what was done in terms of medical, surgical, radiology, pathology, and laboratory services, making it possible for payers to determine reimbursement. Diagnoses are tracked with ICD-10-CM codes, not CPT codes, which is why CPT codes alone don’t report the reason for the encounter. Non-physician services and supplies are typically coded with HCPCS Level II codes, which sit alongside CPT for billing certain items and services that CPT doesn’t cover. An example helps tie it together: a physician performing a colonoscopy would use a CPT procedure code; the reason for the colonoscopy—such as a finding of colorectal polyps—would be coded with ICD-10-CM; a supply like a wheelchair would be HCPCS Level II; demographics like age or gender aren’t coded with CPT. So, CPT codes are used to report procedures and services performed by physicians and other qualified professionals.