Practice Management Alert

Question: What is the new Category II section in CPT, and how do we use it?
- Florida Subscriber

Answer: CPT 2004 introduces the Category II code section, but these codes won't add anything to your reimbursement. The Category II codes track performance measurements. The American Medical Association intends to use these codes to collect data about quality of care. Using Category II codes is optional, and you may not substitute them for the regular Category I CPT codes.

For example: You're trying to track the use of smoking-cessation counseling on a pulmonary rehab patient and you don't have an electronic health record. Reporting one of the new smoking-cessation Category II codes, such as 0004F (Tobacco use cessation intervention, counseling) or 0005F (Tobacco use cessation intervention, pharmacologic therapy), will allow you to do this through your claims data or practice management software rather than by chart reviews.

You would have to make sure you still report the counseling Category I code, linked to an ICD-9 code. Category II codes are simply an optional way of tracking E/M components.

The AMA will publish new Category II codes twice a year: Jan. 1 and July 1. For the most current listing, visit www.ama-assn.org/go/cpt.

Answer edited by Catherine Brink, CMM, CPC.