- The American Medical Association (AMA) develops CPT codes. From the 1960s onward, CPT became the standard of communication between medical agencies and insurance companies, according to the University of Miami's Miller School of Medicine website. CPT is in its fifth version, the first category of which lists a five-digit numerical code along with a brief description of the procedure addressed by the code. Two other categories, II and III, use different code sets for newer medical procedures and technologies.
- Each procedure isn't necessarily assigned the same fee under the same CPT code if a different doctor administers a medical service. For example, even if the code for a physical for two doctors is the same, the doctors still may charge different amounts.
- According to American Health Information Management Association (AHIMA), the five-digit codes contain information briefs about a medical condition, broken down and categorized by number. Insurance companies use the number, and not the description, to determine the compensation amount and which costs will be passed on to the patient.
- CPT coding is almost a science---that is, individuals with knowledge of CPT coding usually work in a specialized field within the medical or insurance industries to ensure correct information is coded and interpreted. Insurance companies may deny claims based on improper CPT coding. However, resources are available to individuals who want to search for a specific CPT code.
- According to the Centers for Medicare & Medicaid Services, the AMA holds the copyright to CPT codes, and they are rarely found for free online, as the AMA makes millions of dollars annually from sale of the codes in book or CD format. Current versions of the CPT code are published annually in book form and are available for purchase online, from bookstore and medical supplier websites. The AMA and other organizations also make CPT codes available online, allowing a person to look up a set number of codes before the fee is charged.
