Claims

The date and timestamp when a CPT procedure code record was last updated in the reference or fee schedule system. Used in data governance and change management workflows to monitor revisions to CPT code attributes, ensuring downstream claims and clinical systems reflect current AMA-published code definitions.

Timestamp recording when a Current Procedural Terminology code record was last updated in the system. Used in claims processing and clinical data warehouses to audit changes to procedure code attributes, fee schedules, or billing rules and maintain data integrity.

The official descriptive label assigned to a Current Procedural Terminology code by the AMA. Used in claims adjudication, remittance advice, and clinical reporting to display a human-readable procedure description alongside the numeric CPT code for billing and documentation purposes.

The unique five-digit numeric or alphanumeric identifier assigned by the AMA to a specific Current Procedural Terminology code. Used in medical claims, prior authorizations, and reimbursement systems to identify billable medical, surgical, and diagnostic procedures performed on patients.

The date on which the condition or clinical indication associated with a billed Current Procedural Terminology code first presented. Used in claims processing to establish medical necessity timelines and support coordination of benefits determinations across payers and episodes of care.

The blood oxygen level for a current procedural terminology code. Used in healthcare data management and clinical workflows. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for cpt management and reporting.

The actual dollar amount reimbursed by a payer for a specific Current Procedural Terminology code on a processed claim. Reflects post-adjudication payment after applying contractual adjustments, patient cost-sharing, and any applicable fee schedule rates for the billed procedure.

The date on which payment was issued by the payer for a claim line associated with a specific Current Procedural Terminology code. Used in accounts receivable tracking, remittance reconciliation, and revenue cycle management to monitor reimbursement timelines and cash flow.

The higher-level Current Procedural Terminology code in a hierarchical grouping under which a more specific child CPT code is categorized. Used in claims analytics and fee schedule management to aggregate procedure utilization and reimbursement reporting across related service categories.

The gross dollar amount designated for payment against a Current Procedural Terminology code during claims adjudication, prior to any offsets or recoveries. Used in revenue cycle analytics to reconcile expected reimbursement against contracted rates and actual remittance data.

The current processing state of a payment associated with a Current Procedural Terminology code on a medical claim, such as pending, paid, denied, or adjusted. Used in revenue cycle management to track claim line resolution and identify outstanding reimbursement issues requiring follow-up.

A proportional value expressed as a percentage related to a Current Procedural Terminology code, such as the coinsurance rate applied, allowed amount percentage, or payment rate relative to a fee schedule. Used in contract modeling, claims adjudication, and reimbursement analysis for procedure-level financial calculations.

The defined time interval during which a Current Procedural Terminology code is considered active, billable, or applicable under a specific fee schedule or contract. Used in claims adjudication and utilization management to validate that billed procedures fall within authorized coverage or contractual effective date ranges.

A telephone contact number associated with a record linked to a Current Procedural Terminology code, such as a billing department or clinical service line contact. Used in claims administration and provider communication workflows to facilitate resolution of denials or inquiries related to specific procedure codes.

An alternate or simplified display name for a Current Procedural Terminology code used in clinical or administrative interfaces when the full AMA descriptor is too lengthy. Supports user-friendly presentation in EHR charge capture screens, remittance documents, and member-facing explanation of benefits statements.

The established charge or allowable dollar amount assigned to a Current Procedural Terminology code, typically reflecting a provider's billed charge or payer fee schedule rate. Used in claims pricing, contract negotiations, and cost transparency reporting to evaluate procedure-level reimbursement benchmarks.

A ranking value assigned to a Current Procedural Terminology code indicating its processing precedence in claims adjudication workflows, such as primary versus secondary procedure sequencing. Used to determine reimbursement order when multiple CPT codes are billed on the same claim for a single encounter.

The heart rate value for a current procedural terminology code. Used in healthcare data management and clinical workflows. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for cpt management and reporting.

The number of units billed for a specific Current Procedural Terminology code on a medical claim, indicating how many times a procedure or service was performed. Used in claims adjudication and utilization review to validate billing frequency against clinical guidelines and payer-defined quantity limits.

The racial or ethnic classification of the patient associated with a Current Procedural Terminology code encounter. Used in healthcare equity analytics and population health reporting to identify disparities in procedure utilization, access to care, and clinical outcomes across demographic groups within claims datasets.