The Surgery Flags Software for Services and Procedures is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases, tools, and software inform decision making at the national, State, and community levels.

Contents:

• Overview of the Surgery Flag Software for Services and Procedures
• License for Use of Current Procedural Terminology, Fourth Edition (CPT�)
• User Guide and Other Resources
• Data Elements Required for Input Dataset
• Downloading Information for the Tool and Documentation
• For More Information, Comments, or Questions about the Surgery Flags Software for Services and Procedures

The Surgery Flags Software for Services and Procedures identifies a subset of Healthcare Common Procedure Coding System (HCPCS) Level I codes, commonly referred to as Current Procedural Terminology (CPT®) codes, as surgical procedures. CPT is a proprietary coding system developed and maintained by the American Medical Association (AMA) for coding services provided by health care professionals. There are three types of five-character CPT codes: Category I, which describe services and procedures performed by providers; Category II, which are used for tracking patient follow up and outcomes; and Category III, which indicate the use of emerging technologies. The Surgery Flags Software-Services and Procedures tool includes CPT codes in the following ranges that include at least some surgical procedures:

• CPT Category I, Surgery:10004–69990
• CPT Category I, Radiology procedures (added in v2019.2): 70010–79999
• CPT Category I, Medicine services and procedures (added in v2019.2): 90281–99607, excluding the evaluation and management codes in the range 99202–99499
• CPT Category III Codes, Temporary codes for emerging or experimental services, technology, or procedures (added v2018): 0042T–0866T

Excluded are all other ranges of CPT Category I codes (i.e., codes specific to anesthesia, pathology and laboratory procedures, evaluation and management services, laboratory analyses, multianalyte assay), any CPT Category II codes, and all HCPCS Level II codes.

CPT codes in the specified ranges are classified as one of three categories:

• A narrowly defined surgery (Narrow) that is usually a major therapeutic procedure
• A more broadly defined surgery (Broad) that includes major diagnostic and invasive minor therapeutic procedures
• Neither a narrowly nor broadly defined surgery (Neither)

U.S. Government Rights
This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the American Medical Association, 330 North Wabash Avenue, Chicago, Illinois 60611. The American Medical Association does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The American Medical Association reserves all rights to approve any license with any Federal agency.

The five-character codes included in the Surgery Flag Software for Services and Procedures are obtained from the Current Procedural Terminology (CPT®), copyright 2019 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five�character identifying codes and modifiers for reporting medical services and procedures.

The responsibility for the content of Surgery Flag Software for Services and Procedures is with the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ) and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Surgery Flag Software for Services and Procedures. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Any use of CPT outside the Surgery Flag Software for Services and Procedures should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms.

CPT is a registered trademark of the American Medical Association.

The following table provides information on where to find the various resources available for the Surgery Flags-Services and Procedures tool. The download section includes all of the referenced materials.

The input dataset must contain an array of CPT codes. These data elements are required for the assignment of the Surgery Flags.

Prior to downloading the Surgery Flags Software for Services and Procedures, users must agree to a license agreement with the AMA for using CPT codes.

Select the Surgery Flags Software for Services and Procedures License Agreement.

Questions regarding the Surgery Flags Software for Services and Procedures may be directed to HCUP User Support through the following channels:

• E-mail: hcup@ahrq.gov
• Phone (toll free): 1-866-290-HCUP