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What are CPT Symbols For?

When medical providers submit bills for services to private insurance companies and public health care providers like Medicare, they need a standard reporting code. CPT, a registered trademark of the American Medical Association or AMA, stands for Current Procedural Terminology. It is the widely accepted billing code. CPT symbols are used as part of the system, serving as shorthand for certain practices.

  1. CPT Editorial Board

    • Three times a year the CPT Editorial Board meets to discuss any issues with the existing codes and their implementation. The board considers any changes to the codes or symbols. New technologies and their need for new codes are also part of the function of the editorial board. Any problems with existing symbols or any proposed changes or additions make up part of the board's agenda.

    New Technology and Revisions

    • Putting the health insurance company or governmental agency on notice about new and revised codes requires symbols. These symbols alert the person processing the claim to make sure to use the most recent code. It avoids claims being processed under old code provisions. A bullet, or black dot, out to the left side of a code indicates a new code not previously used. A triangle to the left side of a code signifies that code has been revised and the code used is in the most recent version of CPT.

    Add-On

    • The plus symbol with a code indicates that additional services besides the primary code were provided by the same physician. Notes in parentheses usually accompany this symbol for further explanation. An asterisk or star besides minor surgery codes indicates the preoperative and postoperative services are included. Payment for those services is separate.

    General

    • Several symbols denote some general procedures; a semicolon in a CPT description denotes that everything to its left applies to the shorter indented descriptions that follow. A dot with a circle around it indicates moderate sedation. Products pending FDA approval are tagged with a lightning bolt symbol. When that product receives approval, the symbol is dropped.

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