The CPT Advisory Committee supports the CPT Editorial Panel, which consists of physicians nominated by national medical societies that are part of the AMA House of Delegates. The CPT Health Care Professionals Advisory Committee sends two representatives. The AMA Board of Directors approves all nominations. The panel consists of 11 physicians nominated by the National Medical Specialty Societies, one physician nominated by the Blue Cross and Blue Shield Association, one physician nominated by America’s Health Insurance Plans, one physician nominated by the American Hospital Association, and one physician nominated by CMS. The AMA CPT Editorial Panel maintains CPT. Category 3 CPT codes are not assigned a value through the RUC process. Such codes are important for data collection and serve to support the inclusion (or exclusion) of new or emergency technology in standard medical practice. Category III CPT codes are temporary codes for new or emerging technology or procedures.The concept is that the use of these codes should facilitate the administration of quality improvement projects by allowing for standardized reporting that captures the performance (or non-performance) of services designated as subject to process improvement efforts. Category II CPT codes are tracking codes designed for the measurement of performance improvement.The Relative Value Scale (RVS) Update Committee (RUC) process assigns relative value units (RVUs) for all Category 1 CPT codes. In general, such codes report services whose effectiveness is well supported in the medical literature and whose constituent parts have received clearance from the US Food and Drug Administration (FDA). Category I CPT codes are assigned to procedures that are deemed to be within the scope of medical practice across the US.Four yours later, the Department published the Final Rule, which selected CPT for reporting physician services (and other medical services) and International Classification of Diseases (9th revision, Clinical Modification), also known as ICD-9-CM for reporting diagnosis codes. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required that the Department of Health & Human Services develop standards for electronic data storage and transmission. In 1987, HCFA also adopted CPT for reporting outpatient surgical procedures. In 1983, the Health Care Financing Administration (HCFA), now CMS, adopted CPT for reporting of physician services for Medicare Part B Benefits. The fourth edition was a major update, and introduced a system for periodically monitoring and updating CPT. The third and fourth editions were released in the 1970’s. The second edition, in 1970, expanded CPT’s scope. The first edition sought to standardize terminology and reporting. In 1966, the AMA published the first edition of CPT, which at that time focused on surgical procedures. CPT HistoryĬPT is owned and maintained by American Medical Association, which has copyright protection on CPT. In fact, a recent on-line survey summarized considerable misconceptions about CPT. Despite its near-ubiquity for reporting physician work, misconceptions about CPT are common. Increasingly, CPT coding captures quality and outcome measures - a feature that is likely to have increasing importance in the era of Pay for Performance (P4P) and the Physician Quality Reporting Initiative. Every day, physicians rely upon Current Procedural Terminology (CPT) to report their services for payment by the Centers for Medicare & Medicaid Services (CMS) and other third-party payers.
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