Urology Coding Alert

Question: What is the new Category II section in CPT code 2004 and how should we use it?

Pennsylvania Subscriber

Answer: CPT 2004 introduces the Category II code section, but these codes probably won't add anything to your reimbursement. The Category II codes track performance measurements.

The AMA 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.  

Suppose you're trying to track a patient's hypertension as part of a diagnosis of end-stage renal disease (585, Chronic renal failure), and you don't have the patient's electronic health record.

Reporting the new blood pressure measurement Category II code, 0001F, will allow you to do this through your claims data or practice management software rather than through chart reviews.

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.