Further Information on CPT Code Sets
By W. Bruce Milliman, ND
(AMA - CPT/Editorial Panel/HCPAC, representing the AANP)
We are happy to report that after our first article written in the AANP eNews last month, inquiries were made with regard to CPT coding around manipulation codes. We thought we would use the questions brought forth to discuss this code set. At this point in time Naturopathic Physicians in Washington State are restricted by law from the use of chiropractic codes. Variations of this problem exist in other states. As a consequence, ND's use either Physical Therapy codes (7010-97546) or Osteopathic codes (98925-98929). Alternatively, some practitioners bundle the procedure into an Evaluation and Management visit (99201-05/99211-15). Since there are many types of manipulation and only a few coding options, the existing codes may not allow for accurate (or any) coding for certain forms of manipulation (for example, craniosacral therapy).
This is a great opportunity to discuss development and introduction of new, more appropriate CPT codes for consideration by the Editorial Panel. In developing new Category I codes the CPT Advisory Committee and the CPT Editorial Panel require:
- That the suggested procedure/service is a distinct service performed by many physicians/practitioners across the United States
- That the clinical efficacy of the service/procedure is well established and documented in U.S. peer review literature
- That the suggested service/procedure is neither a fragmentation of an existing procedure/service nor currently reportable by one or more existing codes
- That the suggested service/procedure is not requested as a means to report extraordinary circumstances related to the performance of a procedure/service already having a specific CPT code.
As you can see, overcoming the constraints implied in paragraph 3 would take a concerted national process involving other practioners groups committed to see this process through. The good news is that we are well positioned with Bruce Milliman, ND as an Advisor in the Health Care Professional Advisory Committee and Eva Miller, ND as Staff (nominated as alternate advisor) for the CPT Editorial panel if such an endeavor were to be desired.