Coding Corner: Quality CPT II Reporting

CPT II Codes
Common Procedural Terminology (CPT) codes are created and maintained by the American Medical Association (AMA) and used to report services rendered for outpatient and office procedures.

CPT Category II codes are used to track performance measures and help decrease the need for record abstraction and chart review, minimizing administrative burdens on healthcare professionals.

CPT Category II codes are comprised of four digits followed by the letter “F”. These codes are intended for data collection around the quality of care provided by coding certain services and/or test results that support performance measures.

CPT II Categories

  • 0001F-0015F Composite
  • 0500F-0584F Patient Management
  • 1000F-1505F Patient History
  • 2000F-2060F Physical Examination
  • 3006F-3776F Diagnostic & Screen
  • 4000F-4563F Therapy/Preventive
  • 5005F-5250F F/U & Outcomes
  • 6005F-6150F Patient Safety
  • 7010F-7025F Structural Measures
  • 9001F-9007F Non-Measure Codes

Payors do not require the use of CPT II codes when submitting claims for services rendered. CPT II codes are supplemental tracking codes used for performance measurement and data collection related to quality and performance measurement, including Healthcare Effectiveness Data and Information Set (HEDIS®).

Use of CPT Category II codes for services performed during office, lab, or facility visits will provide more accurate medical data and close gaps in care more accurately and quickly. This drives HEDIS measures and quality improvement initiatives.

Documentation & Coding
For each CPT II code used, it is important to document the details of what is being reported during the visit. Always use correct diagnosis and procedure codes when submitting claims by ensuring that medical record documentation supports the codes used.

CPT II Quality Reporting


American Medical Association Category II Codes

National Committee for Quality Assurance

About the Author

Amber Malone-Wright, RHIT, CPC, CDEO, CPMA, CRC, CPC-I, CEMC, CCMA

Director of Clinical Document Integrity at CHESS