What is CPT 4? Current Procedural Terminology

The CPT nomenclature was created by the AMA (American Medical Association) approximately 30 years ago.  It is a standard, uniform way to document services and procedures provided to your patients.  The use of this file requires licensing by the AMA. 

You have the option to use CPT as your procedure file, but there are several factors to take into consideration.  The most important advantage of using CPT as your procedure file is its wide acceptance as the medical standard of communication between healthcare providers, physicians, and insurance companies.

The challenge that comes with using CPT is the file’s size.  Since this is such a large procedure file, one consideration is how to keep doctor preference cards from getting to a size that is unmanageable.  Does your facility have practices for data entry that are conducive to keeping the information well managed?  Does your software system provide tiers to map the CPT codes to broader categories?  Another major consideration is the amount of involvement required of the scheduling staff and the nursing staff.  How is the information used in reporting?  How will your facility perform yearly updates?

The chart below provides an example of several CPT codes that routinely have similar resource requirements, or utilize the same preference card.

Consider your options carefully - a hospital defined procedure file may better meet the needs of your facility.  This decision should not be taken lightly due to the direct impact on patient scheduling, preference cards, nursing documentation, and management reporting.