What is CPT (and who cares??!!)
By W. Bruce Milliman, ND, and Eva Miller, ND
(AMA - CPT/Editorial Panel/HCPAC, representing the AANP)
Welcome to the wonderful world of CPT!! You may be asking yourself what the heck is CPT' or, if you already know 'do I care?' CPT stands for Current Procedural Terminology, and it consists of numerical codes which identify each service and procedure that health care providers perform, collated together in an annual publication. The system is managed by the AMA (American Medical Association) www.ama-assn.org
under an agreement with DHHS and CMS (Department of Health and Human Services and the Center for Medicare and Medicaid Services) Anyone who bills insurance or who provides a "super bill" for patients to attempt to get reimbursed for services provided by a naturopathic physician uses CPT codes.
Since 2003, as a member of the American Association of Naturopathic Physicians, you have had a representative on the AMA (American Medical Association) CPT Editorial Panel Advisory Committee (called the Health Care Professional Advisory Committee, or HCPAC) www.ama-assn.org/ama/no-index/physician
. In 2006, the Advisor was joined by a Staff person to help with the Committee work. The Panel now meets three times per year to consider new code proposals, edit existing codes and delete antiquated codes.
History of AANP involvement with CPT:
In 2002-2003, under the leadership of AANP past president Michael Traub ND,DHANP the AANP participated in a process to help all Complementary and Alternative Medicine (CAM) professions gain better access to health care insurance. An alternative code system was also considered, the "ABC Code set" bolenreport.com/feature_articles/feature_article048.htm
. This work was done through the Integrated Healthcare Policy Consortium (IHPC
), then led by Bastyr co founder, Sheila Quinn and IHPC Executive Director, Matt Russell. Meetings throughout 2002 resulted in, amongst others, Alan Dumoff (Attorney with IHPC), Konrad Kail, ND and Bruce Milliman, ND traveling to Washington, DC to testify before the National Committee on Vital and Health Statistics at Health and Human Services (see "Executive Summary" @ www.ncvhs.hhs.gov/030129mn.htm
). The IHPC hosted a two day meeting in Washington, DC with AMA/CPT, ABC code set, and CAM profession representatives, including AANP to facilitate the CAM professions participation in CPT's HCPAC.
Who Are We?
Your initial and continuing Advisor on the AMA CPT Editorial Panel/HCPAC is Bruce Milliman, ND and the Staff person is Eva Miller, ND.
Bruce Milliman graduated in the first Bastyr class, in 1982 and did a three year residency in London at a homeopathic hospital under the tutelage of Chandra Sharma, MD. He served as Bastyr University Clinic Director, then faculty from 1986 through 2006. He has been an advocate for access to health insurance reimbursement to patients for naturopathic services in Washington State and elsewhere in the US since 1995. He has been equally active regarding the needs of non-MD health care service providers. For the last 15 years, he has practiced at Seattle Healing Arts, an integrated health care setting of more than 60 credentialed practitioners.
Eva Miller is a naturopathic physician also in practice at Seattle Healing Arts, and received her medical training at Bastyr University, graduating in 2005. Her interest in CPT developed during her CNME (Council for Naturopathic Medical Education) accredited two and a half year residency under Dr. Milliman. Dr. Miller currently serves as the vice president of the Washington Association of Naturopathic Physicians (WANP www.wanp.org
) and is the designated staff person assisting Dr. Milliman in his capacity as Advisor, representing the AANP on the AMA CPT Editorial Panel/HCPAC. She has been staffing AANP 'HCPAC' advisory position since attending her first meeting with him at the Editorial Panel meeting in October of 2005. It became clear to her how important it was to have our profession represented in a federally recognized organization with other health care associations, and it was also apparent that the position required staffing.
As naturopathic medicine becomes more integrated into the health care arena, as licensure is gained in more states and insurance reimbursement is increasingly utilized, our growth in understanding and continued participation in the CPT process will become ever more important. It is our intention, through this ongoing column in the eNews, to provide you with a source of information regarding insurance, as well as a forum for discussion. Let Drs. Miller and Milliman know your thoughts, concerns and questions regarding health insurance reimbursement in general, or coding in particular. They can be reached at firstname.lastname@example.org