The American Medical Association (AMA) created and published CPT codes in 1966. The first edition was used as a standard of terms and descriptors of documentation for procedures in a patient’s medical record or chart. This system was comprised of a four-digit coding system. The standard of set codes and descriptors helped communicate accurate information on services and procedures performed to assist in accurate payment from insurance carriers and third party payers. It further assisted in the development of software systems to report statistical data. The first edition was comprised primarily of surgical procedures with limited sections on medicine, radiology, and laboratory procedures.
The second edition was released in 1970 and offered a more expansive system of terms and codes to designate diagnostic and therapeutic procedures in surgery, medicine, and the specialties. This version switched from a four-digit coding system to a five-digit coding system along with adding a procedures relating to internal medicine.
In the mid to late 1970’s the third and fourth editions of CPT were released. The fourth edition was released in 1977 offering significant changes and updates in medical technology, and a system of periodic updating.
The Centers for Medicare and Medicaid Services (CMS) adopted and mandated the use of CPT for outpatient hospital surgical procedures in 1987 as part of the Omnibus Budget Reconciliation Act. Today in addition to use in federal CMS programs CPT is used extensively throughout the United States as the preferred system of coding and describing health care services.
In 2002 dental insurance companies started requiring certain dental procedures to be billed on a CMS1500 form to the medical carriers using both ICD-9-CM and CPT codes for payment prior to determining payment under the dental plan.
CPT codes are updated, revised, modified and deleted every year by the CPT editorial panel. The editorial panel is comprised of 17 members, 11 of the members are physicians nominated by the National Medical Specialty Societies and approve by the AMA Board of Trustees. The remaining 6 are members of the panel’s executive committee.
One physician is nominated from each of the following:
• The Blue Cross and Blue Shield Association
• America’s Health Insurance Plans
• American Hospital Association
• Centers for Medicare and Medicaid Services (CMS)
CPT Health Care Professionals Advisory Committee
The Advisory Committee is limited to national medical specialty societies seated in the AMA House of Delegates and to the AMA Health Care Professionals Advisory Committee (HCPAC).