Cracking the Code
Coding Category II Codes
Category II codes, or Performance Measure codes, as used voluntarily by physicians. These codes are recognized by their four numerical digits followed by the letter “F” (for example, 1234F). These codes have no RVU value because they describe clinical components included in Evaluation and Management services, or results from tests and other procedures identified as measurable data for quality patient care.
CPT Category II codes are updated throughout the year and are posted on the AMA website. Professional advisory entities collect performance-measured, evidence-based data to measure the quality of patient care. CPT Category II codes and HCPCS Level II G codes make up the Quality Data Codes (QDCs) for the Quality Payment Program established by CMS. CPT Category II modifiers: 1P, 2P, 3P, and 8P are only appended to Category II codes. Modifiers 1P, 2P, and 3P are exclusion modifiers and are added to indicate that an action specified in a Category II code was not provided because of medical, patient, or system reason. Modifier 8P is a reporting modifier to indicate when an action in the measure is not performed and the reason is not documented.