Dr. Waguespack stressed that most CPT code changes are driven by the evolution of clinical medicine. “Truly obsolete procedure codes may be deleted; most often, new codes are added or existing ones modified to reflect the current practice of otolaryngology. Occasionally, a code’s meaning is ambiguous and must be clarified,” he said. “Another example is a procedure that was always performed in the hospital setting but now is almost exclusively an office or outpatient service, such as intratympanic installation of vestibulo active agents. The forces driving CPT changes are multifactorial and may even involve the code valuation process.”
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November 2021Multipurpose Use
The CPT system serves important purposes beyond billing for practitioners. “CPT allows us to easily track case numbers and is used by the Accreditation Council for Graduate Medical Education for reporting training case volumes,” noted Dr. Lin. “It also allows payers and medical institutions to follow productivity with a great deal of specificity. Because of the widespread nature of CPT through the field of medicine, these benefits are shared by all specialties.”
Certainly, in an increasingly datadriven society, and when so much of medicine is moving toward a digital format, CPT is increasingly vital. “In today’s high-volume, high-activity areas, CPT describes how care is being delivered and how innovation in medicine is applied,” said McGraw. “The codes themselves have structure to them, they have modifiers, they have other mechanisms to describe the specifics at a level of detail that is particularly helpful for the data liquidity that is so needed across the U.S.—and across the globe, actually.”
The people who keep the CPT machine running realize that it can only remain truly effective to the extent that the medical community is well educated in its use and involved in its evolution. “As with any tool, CPT can be misused or misunderstood by physicians and their staffs,” acknowledged Dr. Waguespack, who noted that recent changes have been made to reduce administrative reporting burdens, such as the revision of office-based new and established patient evaluation and management codes that went into effect in 2021. “This supersedes the old CMS 1995 and 1997 guidelines that required very detailed, but sometimes irrelevant, documentation and contributed to a copy-andpaste approach to medical records. The current process focuses on time spent by the physician or well-defined medical decision making.”
The upcoming expansion of the editorial panel is designed to broaden representation across medicine. “I really encourage people to explore CPT, whether they’re innovators, company reps, or physicians who want to participate in the profession of the code set that represents the care that they deliver,” said McGraw. “We’ve done so much to make it available, and we encourage people to attend these meetings so they can see how the process works.”