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HCPCS Level I codes


CPT Book classifications

The CPT book comprises of Level I HCPCS codes maintained by American Medical Association classified these codes into six major groups,

1. Evaluation and Management (E/M) Codes starts from 99201 to 99499
2. Anesthesiology Codes starts from 00100 to 01999
3. Surgery Codes starts from 10000 to 69990
4. Radiology Codes starts from 70010 to 79999
5. Pathology and Laboratory Codes starts from 80002 to 89399
6. Medicine Codes starts from 90281 to 99607

These set of CPT codes in each groups are organized into various categories and levels. It is the physician’s responsibility to ensure that documentation reflects the services furnished and that the codes selected reflect those services. The more work performed by the physicians, the higher the level of code they may bill within the appropriate category. The billing specialist or alternate source reviews the physician’s documented services and assists with selecting codes that best reflect the extent of the physician’s personal work necessary to furnish the services.

The CPT code range and its sub-classifications are detailed as follows

Evaluation and Management (E/M) CPT 99201 - CPT 99499

99201 - 99215 Office or other outpatient services

99217 - 99220 Hospital observation services

99221 - 99239 Hospital inpatient services

99241 - 99255 Consultations

99281 - 99288 Emergency department services

99291 - 99292 Critical care services

99304 - 99318 Nursing facility services

99324 - 99337 Domiciliary, rest, home, (eg, boarding home), or custodial care services

99339 - 99340 Domiciliary, rest, home, (eg, assisted living facility), or home care plan oversight services

99341 - 99350 Home services

99354 - 99360 Prolonged services

99366 - 99368 Case management services

99374 - 99380 Care plan oversight services

99381 - 99429 Preventive medicine services

99441 - 99444 Non-Face-to-Face Physician Services

99450 - 99456 Special evaluation and management services

99460 - 99465 Newborn Care Services

99466 - 99480 Inpatient neonatal intensive care services and pediatric and neonatal critical care services

99499 Other evaluation and management services

For more information on E & M service guidelines, please click the link


http://www.cms.hhs.gov/MLNProducts/Downloads/eval_mgmt_serv_guide.pdf


Anesthesia Codes CPT 00100 - CPT 02101

00100 - 00222 Head

00300 - 00352 Neck

00400 - 00474 Thorax (chest wall and shoulder girdle)

00500 - 00580 Intrathoracic

00600 - 00670 Spine and spinal cord

00700 - 00798 Upper abdomen

00800 - 00884 Lower abdomen

00900 - 00955 Perineum

01000 - 01190 Pelvis (except hip)

01200 - 01274 Upper leg (except knee)

01300 - 01444 Knee and popliteal area

01460 - 01522 Lower leg (below knee, includes ankle and foot)

01600 - 01682 Shoulder and axilla

01700 - 01784 Upper arm and elbow

01800 - 01860 Forearm, wrist, and hand

01900 - 01944 Radiological procedures

01951 - 01953 Burn excisions or debridement

01958 - 01969 Obstetric

01980 - 02101 Other procedures

Surgery Codes CPT 10000 - CPT 69990

10000 - 10022 General

10040 - 19499 Integumentary system

20000 - 22999 Musculoskeletal system: general, head, neck (soft tissues) and thorax, back and flank, spine, abdomen

23000 - 26989 Musculoskeletal system: shoulder, upper extremity

26990 - 28899 Musculoskeletal system: pelvis and hip, lower extremity

29000 - 29909 Musculoskeletal system: casts and strapping, arthroscopy

30000 - 32999 Respiratory system

33010 - 37799 Cardiovascular system

38100 - 38999 Hemic and lymphatic systems

39000 - 39599 Mediastinum and diaphragm

40490 - 42999 Digestive system: lips to pharynx

43020 - 46999 Digestive system: esophagus to anus

47000 - 49999 Digestive system: liver, pancreas, abdomen, peritoneum, omentum, hernia repairs

50010 - 53899 Urinary system

54000 - 55899 Male genital system

55920 - 55920 Reproductive System Procedures

55970 - 55980 Intersex surgery

56300 - 56399 Laparoscopy / hysteroscopy

56405 - 58999 Female genital system

59000 - 59899 Maternity care and delivery

60000 - 60699 Endocrine system

61000 - 64999 Nervous system

65091 - 68899 Eye and ocular adnexa

69000 - 69990 Auditory system

Radiology Codes CPT 70010 - CPT 79999

70010 - 76499 Diagnostic radiology ( diagnostic imaging )

76506 - 76999 Diagnostic ultrasound

77001 - 77032 Radiologic Guidance

77051 - 77059 Breast, Mammography

77071 - 77084 Bone / Joint Studies

77261 - 77799 Radiation oncology

78000 - 79999 Nuclear medicine

Pathology and Laboratory Codes CPT 80002 - CPT 89399

80047 - 80092 Organ or disease oriented panels

80100 - 80103 Drug testing

80150 - 80299 Therapeutic drug assays

80400 - 80440 Evocative/suppression testing

80500 - 80502 Consultations (clinical pathology)

81000 - 81099 Urinalysis

82000 - 83887 Chemistry

83890 - 84999 Molecular diagnostics

85002 - 85999 Hematology and coagulation

86000 - 86804 Immunology

86805 - 86849 Tissue typing

86850 - 86999 Transfusion medicine

87001 - 87999 Microbiology

88000 - 88099 Anatomic pathology: postmortem examination

88104 - 88199 Anatomic pathology: cytopathology

88230 - 88299 Anatomic pathology: cytogenetic studies

88300 - 88399 Surgical pathology

88720 - 88741 In Vivo (eg, transcutaneous) laboratory procedures

89049 - 89240 Other procedures

89250 - 89399 Reproductive medicine procedures

Medicine Codes CPT 90281 - 99607 CPT

90281 - 90799 Immunizations and injections

90801 - 90899 Psychiatry

90900 - 90915 Biofeedback

90918 - 90999 Dialysis

91000 - 91299 Gastroenterology

92002 - 92499 Ophthalmology

92502 - 92700 Special otorhinolaryngologic services

92950 - 93799 Cardiovascular

93875 - 93990 Non-invasive vascular diagnostic studies

94002 - 94799 Pulmonary

95004 - 95199 Allergy and clinical immunology

95250 - 95251 Endocrinology

95805 - 96020 Neurology and neuromuscular procedures

96040 - 96040 Medical genetics and genetic counseling services

96100 - 96125 Central nervous system assessments / tests (eg, neuro - cognitive, mental status, speech testing )

96150 - 96155 Health and behavior assessment / intervention

96360 - 96549 Hydration, therapeutic, prophylactic, diagnostic injections and infusions, and chemotherapy and other highly complex drug or highly complex biologic agent administration

96567 - 96571 Photodynamic therapy

96900 - 96999 Special dermatological procedures

97001 - 97799 Physical medicine and rehabilitation

97802 - 97804 Medical nutrition therapy

97810 - 97814 Acupuncture

98925 - 98929 Osteopathic manipulative treatment

98940 - 98943 Chiropractic manipulative treatment


The American Medical Association (AMA) published its corrections document for the year 2009. Please view the following link to know these corrections for enhanced coding

http://www.ama-assn.org/ama1/pub/upload/mm/362/2009cptcorrections.pdf
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