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AMA gives public first crack at updated 2013 CPT code sets


The time for staking claims has finally arrived.

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Yesterday, the American Medical Association unveiled its 2013 Current Procedural Terminology (CPT) code set for public scrutiny, simultaneously wrapping up yet another annual effort made by all of medicine to capture and articulate the latest scientific advances in the field. What’s more, the new CPT code set should be used to start cracking into claims filed as of Jan. 1, 2013.

"Medical knowledge is constantly advancing and as steward of CPT, the AMA invests extensive resources each year to keep the code set current with contemporary medical science and technology so it can fulfill its vital role as the health system's universal language for reporting medical procedures," said AMA President Jeremy A. Lazarus, MD, in a news release.

The grandest expansion in the code set comes, surprisingly, at the molecular level, with the recent advancements made by the Human Genome Project and other similar initiatives to test and understand disease on a molecular basis. According to the AMA, 116 molecular pathology codes now exist as a result of said programs, which started garnering CPT ciphers in 2012. Added CPT encryptions for the upcoming year will allow for innovative diagnostic codes to report more openly and succinctly, thus allowing medical professionals to reduce disease burdens, improve health outcomes and reduce long-term care costs. The 116 gets even sweeter — reflecting the general and technological leaps and bounds physician practices have made in cardiology, neurologic testing and psychiatry at an impressive scale.   

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"Ensuring that CPT codes accurately reflect the medical care provided to patients is only possible through the dedication and direct input of practicing physicians, allied health professionals and advisors from more than 100 medical specialty societies," Lazarus continued. "Tapping into the clinical expertise of the healthcare community produces the practical enhancements that CPT needs to reflect the coding demands of the modern healthcare system."

The updated codes also serve to better summarize the processes involved in managing patients with chronic conditions of the more complex variety when incorporating a new integrated delivery system, such as patient-centered medical homes and accountable care organizations. Medical staffers will now have the ability to better report time spent connecting patients to community outreaches; intervals needed to transition patients from inpatient status to alternative settings; and the girth of readmission prevention for a given health entity.

"The newest edition of the CPT code set is a good example of how the AMA and organized medicine are working jointly in summarizing complicated medical services with a simple five-digit numeric code," Lazarus said in conclusion. "Prior to CPT's universal adoption in 1983, the healthcare system struggled to cope with multiple code sets for reporting procedures, most of which had inadequate input from the medical profession. The American healthcare system has greatly benefited in the last 30 years by the creation and continual updating of CPT as the uniform standard for efficiently communicating vital information between physicians, hospitals and health plans."

The AMA attributed 2013 CPT code success partially to the tremendous input provided by many members of the healthcare realm. The organization plans to share more about the latest CPT additions at the CPT/RBRVS Symposium, to be held in Chicago from Nov. 14-16. [See also: ICD-10 revenue neutrality: 9 ways to protect your cash flow]

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