What information does a CPT code provide to insurance companies?

CPT codes, or Current Procedural Terminology codes, are a standardized set of codes used to describe medical, surgical, and diagnostic services and procedures. When submitted to insurance companies, these codes provide essential information about the specific procedure that was performed on the patient. This level of detail allows insurance providers to understand the services rendered, assess coverage eligibility, and determine reimbursement amounts.

The precise coding helps streamline the billing process and ensures that all parties involved—healthcare providers, patients, and insurance companies—have a clear understanding of what care was provided. Using accurate CPT codes is crucial for proper claim processing and for the healthcare provider to receive appropriate compensation for the services rendered.

In contrast, the other options do not accurately reflect what CPT codes represent: they do not provide prognostic information, the identity of the physician, or the patient's identification number. Instead, they focus strictly on the procedures and services performed, highlighting the critical role CPT codes play in healthcare billing and insurance processes.