Specific criteria for Category III codes: emerging technology
The following criteria are used by the CPT/HCPAC Advisory Committee and the CPT Editorial Panel for evaluating Category III code applications:
- The procedure or service is currently or recently performed in humans AND
- At least one of the following additional criteria has been met:
- The application is supported by at least 1 CPT or HCPAC Advisor representing practitioners who would use this procedure or service (or)
- The actual or potential clinical efficacy of the specific procedure or service is supported by peer reviewed literature which is available in English for examination by the CPT Editorial Panel (or)
- There is:
- At least 1 Institutional Review Board approved protocol of a study of the procedure or service being performed
- A description of a current and ongoing United States trial outlining the efficacy of the procedure or service or
- Other evidence of evolving clinical utilization