Category III CPT Codes

Abstract

This new section of Physicians’ Current Procedural Terminology (CPT®) contains a set of temporary codes for emerging technology, services, and procedures. Category III CPT codes will allow data collection for these services and procedures, which are used to substantiate widespread use or in the Food and Drug Administration (FDA) approval process. As such, Category III CPT codes may not conform to the usual CPT code requirements thatServices and procedures must have relevance for ongoing or planned research.These codes will be assigned an alphanumeric identifier with a letter in the last field (eg, 1234T). They will be located in a separate section of CPT following the “Medicine” section. Introductory language will be placed in this section to explain the purpose of the codes.Category III CPT codes are intended to be used for data collection purposes; they are not intended for services and procedures that are not accepted by the CPT Editorial Panel because the proposal was incomplete, more information is needed, or the Advisory Committee did not support the proposal.Once approved by the CPT Editorial Panel, the newly added Category III CPT codes will be made available on a semiannual (twice yearly) basis via electronic distribution on the Web (http://www.ama-assn.org/ama/pub/article/3885-4897.html). The full set of Category III CPT codes will be included in the next published edition of that CPT cycle.Category III CPT codes will not be referred to the American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee for valuation because no relative value units will be assigned. Payment for these services and procedures is based on the policies of payers and not a yearly fee schedule.These codes will be archived after 5 years if they have not been accepted for placement in the Category I section of CPT, unless it is demonstrated that a Category III CPT code is still needed. These codes will not be reused.It is important to note that because future CPT Editorial Panel or Executive Committee actions may affect these items, codes and descriptor language may differ at the time of pub-lication in CPT 2004. Also, future panel actions may result in gaps in code number sequencing. A cross-reference will appear in the Category III section of CPT to direct users to the newly established Category I CPT code.The following new section of introductory language and codes will be published in CPT 2004. The ▸◂ symbols indicate new text has been added. The • symbol indicates new procedure codes have been added to CPT. The + symbol indicates an add-on code.