CPT® code change applications

All code change applications are to be submitted online via the CPT® Smart App. The CPT® Smart App platform transforms the application submission process from a paper-based application process to a digital set of tools and resources for proposing code changes. This platform allows easy access to the current CPT® data set and provides tools to manage your code change applications.

CPT® Smart App

Submit an online application with the CPT® Smart App.

Start Your Application

Currently, electronic submissions using the CPT® Smart App are required for:

• Category I/III
• Category I “Short Form”
• Pathology/Laboratory (including MoPath/GSP/MAAA)

The PLA code change application is managed through the PLA online system.

For Category II code changes, the paper application will continue to be the required submission format, until further notice.

May 5, 2020: The Molecular Pathology Advisory Group (MPAG), Pathology Coding Caucus (PCC) and CPT® Editorial Panel created a new, consolidated Pathology/Laboratory Code Change Application. To help applicants and preparers better understand the new application’s structure and benefits, the CPT® Editorial Processes team created a video walkthrough of the entire Pathology/Laboratory Code Change process.

 

 

Review the key functionalities (PDF) of the CPT Smart App and additional common questions from applicants and preparers. (Due to technical issues, the webinar was unable to be recorded).

Learn how the CPT Smart App is streamlining the digital application process and improving accessibility of CPT content, including the latest CPT Code set.

 

 

The AMA has created a series of six instructional courses on the CPT Code Change Application Process and the CPT Smart App. These courses have videos on how to use the CPT Smart App and give examples on the types of responses that represent the information that the CPT Editorial Panel (Panel) needs to review the code change applications. The courses are:

Course 1: Pre-training and CPT course overview

Explains the new CPT Smart App online system and offers an overview of the CPT code change process.

Course 2: Basic and required entries

Describes the elements that are required to complete and submit the applications.

Course 3: Code changes

Provides instructions for rationale and process for completing code changes.

Course 4: Data collection

Describes how to complete the Data Collection screens.

Course 5: Physician services, vignette, supporting information/literature

Provides instructions for physician descriptions, patient vignettes, procedure descriptions, and the process of including supporting documentation and literature.

Course 6: Submit, re-submit and download an application and documents

Explains the processes for submitting and re-submitting a CPT code change application and downloading documents.

Reference materials for CPT Smart App applications

The documents in this section provide guidance on how to add and revise CPT codes, what type of bundling is appropriate for imaging guidance and where to find and place Pathology/Laboratory codes. To review application form questions before submitting the form, visit the CPT Smart App and create a draft without answering questions. Then download the empty draft and review the questions offline. Paper applications are not accepted; all applications must be submitted via the CPT Smart App.

• Code descriptor formatting instructions (DOCX)
• Image bundling decision tree (PDF) 
• Pathology/laboratory code placement guidelines (PDF)

Paper applications will continue to be required for the Category II code change application. Please review the submission instructions before submitting a paper application.

• Category II code change submission instructions

Visit the PLA online system to submit an application for Proprietary Laboratory Analyses (PLA) code changes.

• Proprietary Laboratory Analyses (PLA) code change application (sign in required)

The literature requirements set in the following documents define the minimum requirements for CPT Editorial Panel (“Panel”) consideration of the Category I/III Long Form and Pathology/Laboratory applications

• Category I & Category III CPT® literature requirements (DOCX)
• Pathology/Laboratory (including MoPath/GSP/MAAA) literature requirements (DOCX)

All CPT code change applications must meet the following requirements in order to be placed on the agenda of the CPT Editorial Panel as an item of business:

• Submission of a current, complete and materially compliant application form and all other necessary supporting documents
• Adherence to all posted deadlines
• Full cooperation with requests from CPT staff and/or Editorial Panel members for clarification and information
• Compliance with all applicable policies and procedures including the CPT lobbying policy, confidentiality agreement (PDF) and conflict of interest disclosure requirements (PDF) (DocuSign® electronic signature may be required)

CPT staff initially receives and reviews applications for compliance with the above requirements. If necessary, CPT staff will reach out to the applicant for additional information. Applicants have three (3) business days to satisfactorily respond to CPT staff requests unless another deadline is stated. Applications that fail to meet the requirements, as specified above, will not be placed on the CPT Editorial Panel agenda for the immediate Panel meeting. Applicants are welcome to reapply for a subsequent meeting.

Submit an online application with the CPT Smart App.

• CPT Appendix S: Artificial intelligence/augmented intelligence (AI) taxonomy for medical services & procedures

• CPT® Appendix A Modifier 93 (audio only medical services)

If you have questions concerning the application process, please contact us.

CPT® is a registered trademark of the American Medical Association.