30 Second Insurance Tips©

Tip 151- CPT Codes

Our health insurance claims are based off the “Current Procedural Terminology” (CPT) code set maintained by the American Medical Association. Updated annually, there are presently 9,641 CPT codes.

For preventive services alone –and I’m in over my head here – it would appear there are no less than 16 CPT variations (99381-99397). For “problem oriented” preventive services, add in another 14 CPTs (99201-99215).

Armed with a CPT code before services are rendered, consumers now have access to a host of cost estimator tools.

For example, at www.fairhealthconsumer.org, I found the cost of a colonoscopy (CPT 45378) would average $1,941; a colonoscopy with polyp removal (CPT 45385) would average $2,750.

Your health insurer’s website may have better information; possibly even integrated with your plan design.

With ever higher deductibles and coinsurance, shopping for health care has never been more important.