Question

What are Category III codes?

Answer 1

Category III codes first emerged in 2001. The American medical Association (AMA) developed category III CPT codes to track the utilization of emerging technologies, services and procedures. It provides the description which does not establish a procedure or service to be safe, effective or applicable to clinical medicine.The Category III code process was created to provide a means to establishing specific codes for new procedures and technology that do not meet the code for category I cpt code. It is also referred to as 'T' codes, because they all have the format of having four letters followed by the letter T eg:0177T

Background information for Category III codes

These codes are intended to be used for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration Approval. The CPT category III codes may not conform to one or more of the following CPT I code requirements

1. All devices and drugs necessary for the performance of the procedure have received FDA clearance or approval
2. The procedure is performed by many qualified health care professionals/ physicians across the United States
3. The procedure or service is performed with frequency consistent with intended clinical use
4. The procedure or service is consistent with current medical practice
5. The clinical efficacy of the procedure or equipment is documented in literature that meets the requirements set forth in the CPT code change application

This is an activity that is critically important in the evaluation of health care delivery and in the formation of ublic and private policy