Tuesday, December 29, 2020

Remarkably, CMS Will Let You Download Full CPT Code Names

Generally, the full names of CPT codes are copyright AMA and used in limited ways by payers, including CMS and its MACs.   However, abbreviated names are used more freely.  For example, you may get CPT edit lists or fee schedules that show the CPT code along with a very brief abbreviated code descriptor.

However, if you're willing to go 2 years into the past, you can apparently see nearly full code name descriptors via the CMS physician/code utilization website.  Find the 2018 data here:

https://www.cms.gov/research-statistics-data-systems/medicare-provider-utilization-and-payment-data/medicare-provider-utilization-and-payment-data-physician-and-other-supplier/physician-and-other-supplier-data-cy-2018

Go to the HCPCS Aggregate Data, and you'll see a cloud database of 13000 lines.  The first column is CPT/HCPCS code and the second column seems to be the full descriptor name.   You can click on "export" to produce an Excel CSV table, which can be re-saved inside Excel as an Excel XLS table.

The code name descriptors aren't the FULL ones, but they're pretty long.   


There are Excel functions that will let you take index codes (such as CPT code) in a CMS table like the CLFS Fee Schedule, and search for a corresponding rows/columns in another spreadsheet and import cells.   So you could import these field names into a copy of the CLFS even if the CLFS had only digital CPT codes to mark the rows.  

The names are a little funny, for example, 81246 is FLT3 gene, Tyrosine Kinase varians, in the full CPT manual, and here it's shortened to "testing for genes associated with blood cancer) and a daughter code for 81245 FLT3, which is here called "gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants."  The corresponding Short Names in the CMS CLFS table are 81426, FLT3 gene analysis, and 81425, FLT3 gene.

In the table above, I've created the "sum of dollars" column at the far right, which CMS doesn't provide in this view. 
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Additionally, you can get usage data by CPT code in Excel files from CMS called National Summary Data File, for 2019 (here) which has ONLY CPT code digits as row markers, and use the above data to import full code names - at least for all the codes that were in use in both 2018 and 2019.

There are different ways of doing this lookup function, one is called VLOOKUP, e.g.




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