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CPT II codes are supplemental tracking codes used to capture clinical data, mainly for quality reporting and performance measurement. The purpose of CPT II codes is NOT for billing or reimbursement. They help healthcare organizations monitor outcomes, close care gaps, and demonstrate compliance with programs such as MIPS, ACOs, and HEDIS. CPT II codes play a key role in the broader shift toward value-based care models.
CPT II Codes in ThoroughCare
CPT II codes can convey a myriad of outcomes, ranging anywhere from kidney function tests to weight measurements.
As of October 2025, ThoroughCare offers CPT II codes for blood pressure readings.
When blood pressure readings are taken, a CPT II code for the patient's latest reading for the current month will be generated. ThoroughCare will automatically assign a CPT II code for the patient's latest systolic and diastolic readings, so there will be two CPT II codes visible for the patient after their blood pressure readings are taken.
The codes and associated parameters for the systolic & diastolic readings are as follows:
Systolic or Diastolic? | Range (mm Hg) | CPT II Code |
Systolic | < 130 mm Hg | 3074F |
Systolic | 130 mm Hg - 139 mm Hg | 3075F |
Systolic | >= 140 mm Hg | 3077F |
Diastolic | < 80 mm Hg | 3078F |
Diastolic | 80-89 mm Hg | 3079F |
Diastolic | >= 90 mm Hg | 3080F |
The CPT II codes can be viewed in the billing & claims worklist and the patient's billing tab, under the "CPT Code" column.
For example, here is a patient whose latest blood pressure readings are reflected as CPT II codes. Below, you can see the patient's latest blood pressure reading in the red rectangle.
Now in this patient's Billing tab, the user will be able to see the CPT II codes reflected in the claim.
This will also be reflected in the Billing and Claims worklist.
Submitting CPT II Codes to EHR Claims
To ensure CPT II Codes transmit correctly to your EHR, you might need to update your fee schedule. Here is an example of how this is typically done for Athena.
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