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CODE.MODE

CPT- CATEGORY II 

Category II Codes

 

Category II codes are a set of supplemental tracking codes used for performance measurements. These codes are part of a voluntary program and are optional, which means they are not required for correct coding. These can NEVER replace Category I codes. 

LAYOUT

Modifiers

 

Category II codes have their own set of modifiers to indicate why a service was considered, but not provided. 

These are only reported with Category II codes, and only where specified in the guidelines, reporting instructions, parenthetic notes, or code descriptor language in the corresponding section. 

NEVER report these with Category I or Category III codes!

Sections

Like Category I codes, Category II codes are divided into different code sets. 

Guidelines

Guidelines are listed at the beginning of each cluster of codes, to provide specific instructions for that code set. Reporting instructions, parenthetic notes, and further details are also listed within for further specification.  

PROCEDURAL

FORMAT

Five-Character Codes (4 digits and letter "F")

####F

SECTIONS

  • Composite Codes

  • Patient Management

  • Patient History

  • Physical Examination

  • Diagnostic/ Screening Processes or Results

  • Therapeutic, Preventative, or Other Interventions

  • Follow-up or Other Outcomes

  • Patient Safety

  • Structural Measures

  • Non-measure Code Listing

MODIFIERS

  • Category II Modifiers

PUBLICATION

  • AMA

  • Annually:

    • Late Summer or Early Fall

    • Electronic Data Files / Books

  • Effective January 1

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