What CPT codes are
CPT stands for Current Procedural Terminology. These codes are maintained by the American Medical Association and used by all US providers and insurers to identify specific procedures. Every itemized procedure line has a CPT code.
Why they matter
The CPT code determines how much your insurer pays. Billing errors often involve the wrong code — either by mistake or through upcoding, where a more expensive code is used than the service warrants.
UpcodingBilling for a more complex service than was provided — e.g. billing a level 5 office visit (99215) for a routine visit (99213). If a code doesn't match your experience, it's worth questioning.
How to check a code
Look up any CPT code using free online tools. Compare the description to the service you received. If it doesn't match, ask the billing department to explain or request a review.
General information only. Not legal or medical advice.