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Oncology & Hematology Coding Alert

Reader Question:

Track E/M Components Using New CPT Section

Published on Thu Jan 01, 2004

Question: A colleague told me that CPT 2004 includes a new code category. What is it and how will we use it?

Delaware Subscriber

Answer: Yes, CPT introduces Category II codes for 2004. Although you may report more codes, you won't see any additional reimbursement. 
 
CPT's new Category II adds supplemental tracking codes for performance measurements. AMA adds this section to comply with HIPAA regulation requirements. These codes will not affect reimbursement. Instead, AMA hopes that these codes will facilitate data collection about quality of care, and some of the codes may relate to healthcare professionals' compliance with state or federal law. You should be aware of the following:
 

  • AMA makes using Category II codes optional, and you may not substitute them for the regular Category I CPT codes.
     
  • Category II codes describe components that CPT typically includes in an E/M service or test results that are part of the  laboratory test/procedure.
     
  • Category II codes have no relative value units assigned to them.

    AMA will release new codes for this section semi-annually, and you can find them on the AMA/CPT Web site www.ama-assn.org/ama/pub/category/3885.html. They will be published in the CPT each year.

     The Category II codes that will be effective Jan. 1, 2004, are:
     

  •  0001F - Blood pressure, measured
     
  •  0002F - Tobacco use, smoking, assessed
     
  •  0003F - Tobacco use, non-smoking, assessed
     
  •  0004F - Tobacco use cessation intervention, counseling
     
  •  0005F - Tobacco use cessation intervention, pharmacologic therapy
     
  •  0006F - Statin therapy, prescribed
     
  •  0007F - Beta-blocker therapy, prescribed
     
  •  0008F - ACE inhibitor therapy, prescribed
     
  •  0009F - Anginal symptoms and level of activity, assessed
     
  •  0010F - Anginal symptoms and level ofactivity, assessed using a standardized instrument ...
     
  •  0011F - Oral antiplatelet therapy; prescribed (e.g., aspirin, clopidogrel/Plavix, or combination of aspirin and dipyridamole/Aggrenox).

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