Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingMedium
A physician's office wants to report data on quality performance measures, such as tobacco screening rates, without affecting reimbursement. Which CPT code category should be used for this purpose?
- ACategory II
- BCategory IV
- CCategory I
- DCategory III
Show answer & explanationAnswer & explanation
Correct answer: A. Category II
CPT Category II codes are supplemental tracking codes used for performance measurement and quality reporting; they are not linked to reimbursement and are optional. Category I codes are the standard procedure/service codes, Category III codes are temporary codes for emerging technology, and there is no 'Category IV.'
Why the other options are wrong
- B. There is no Category IV in the CPT coding system.
- C. Category I codes describe standard procedures/services and carry RVU-based reimbursement.
- D. Category III codes are temporary codes for new/emerging technologies and procedures.
CPT Code Categories
CPT codes are divided into three categories: Category I (standard procedures/services), Category II (performance measurement, optional, no reimbursement), and Category III (emerging technology, temporary).
- Category I = 5-digit numeric codes for reimbursable services
- Category II = alphanumeric codes ending in F, used for quality tracking
- Category III = alphanumeric codes ending in T, temporary for new technology
Memory trick: I bills, II tracks quality, III is temporary tech