by Find-A-Code™
Mar 26th, 2024
The American Medical Association (AMA) published an announcement in mid-January discussing some minor changes to the Common Procedural Terminology (CPT) Category III Long Descriptor document. For us, the bulletin served as a reminder that often obscure, category III codes are still important.
You can read the AMA announcement here if you have not already done so. But to summarize, the changes for 2024 include:
- The addition of thirty-four codes (0867T-0900T)
- Parenthetical notes and revisions under 0714T
- An update to the parenthetical note in 0898T
As always, it is up to medical coders and billers to stay abreast of the changes to CPT codes. As a coder or biller, you are welcome to visit the AMA website where you can download PDF copies of their announcements.
Category III Codes Are Temporary
CPT category III codes tend to be obscure because they are related to emerging technologies, procedures, therapies, etc. They are also temporary codes. That is what makes staying abreast of changes so important. When the AMA makes changes, medical billers and coders need to know right away.
If you are not familiar with category III codes, look for the letter 'T' at the end. This designates 'temporary'. The letter 'T' being assigned to a code indicates that it is a category III code. It likely refers to some sort of novel technology, service, or procedure.
The Status Will Change
The temporary status of every category III technology, service, and procedure will eventually change. As long as the procedure continues to be referenced with a temporary code, the AMA is waiting to see the results. If its use becomes widespread and its efficacy deemed legitimate, the procedure will ultimately be assigned a permanent code. Otherwise, it will eventually be dropped from the CPT code set altogether.
In essence, category III codes are placeholders. They describe emerging technologies and therapies that are currently being tracked by healthcare professionals. Tracking provides essential data on:
- Utilization – Both healthcare professionals and the AMA want to know how an emerging procedure or therapy is being utilized in real world settings. This provides a clearer understanding of its potential impact.
- Efficacy – Obviously, an emerging procedure or therapy needs to be tracked for efficacy. If it is not proving efficacious, it will eventually be abandoned.
- Outcomes – Outcomes relating to an emerging procedure or therapy are tracked for a better understanding of the benefits and risks. Positive outcomes need to outweigh potential risks to make the therapy or procedure worthwhile.
Over a set period of time, all the data compiled during tracking determines the fate of the procedure or therapy in question. With that in mind, it is critically important that medical coders and billers use the right category III codes so as to ensure the right data is being tracked.
Making Healthcare Better
Though most people do not fully appreciate it, medical coding partially determines the direction medical research takes. For example, by offering temporary category III codes, the AMA is helping foster innovation by way of tracking emerging therapies, procedures, and technologies prior to eventual FDA approval.
Category III codes also improve quality of care by providing important clinical data in real time. And of course, category III codes also promote both transparency and accountability by clearly designating procedures, services, and technologies that are still emerging.
As a medical coder or biller, you do your best to stay on top of changes to CPT code sets. Be sure to give appropriate attention to category III codes. We are here to help with up-to-date online data that is always ready and at your fingertips.
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