CPT® Coding Change Process Cover Memo

Memo to: CPT® Coding Change Requestor

From: CPT® Editorial Research and Development

Subject: CPT® Coding Change Process

Thank you for your inquiry regarding a CPT® coding change. Attached is a copy of the Coding Change Request Form required to initiate the CPT Process. In order to establish new CPT codes, an individual, a physician, or a specialty group may submit a request. Also attached are the Coding Change Request Form Instructions with requirements for the specific category of code change requested.

The Coding Change Request Form plays a vital role in maintaining and increasing the efficiency of the CPT Process. If your proposal will be lengthy, please submit a copy of you proposal on a 3½ inch diskette, Microsoft Word preferred. This greatly assists American Medical Association (AMA) staff in the preparation of the material for review by the CPT Advisory Committee and the agenda material for the CPT Editorial Panel.

As noted in the enclosed instructions, the clinical vignettes you submit for proposed CPT codes should contain the following elements: the typical patient and the work provided by the health care provider. Clinical vignettes are helpful in the establishment of appropriate work values by the AMA/Specialty RVS Update Committee (RUC).

National statistical data is required by both the CPT Editorial Panel and the RUC regarding the performance of each procedure requested. This is an important factor that the CPT Editorial Panel reviews, as outlined in the introduction to CPT. In order for the CPT Editorial Panel to add a new Category I code, documentation must be included to indicate that the procedure(s) has a widespread usage and acceptance.

It would be helpful to include copies (or internet addresses) of any or several published articles (in U.S. medical publications) related to this procedure. This does not include, however, those articles published in foreign medical journals. These articles assist to substantiate the consistent performance of a procedure and are reviewed by the CPT Advisory Committee members and the CPT Editorial Panel during the CPT Process.

Optionally, you may submit this proposal to the appropriate medical specialty society(ies) for review and assistance, specifically regarding national usage and acceptance of this procedure and assistance the clinical vignette.

If you have any further questions or need any further assistance in completing the forms, please do not hesitate to contact CPT Editorial Research and Development staff at 312-464-4723 or via fax at 312-464-5762. Please visit our CPT Web Site.

CPT is a registered trademark of the American Medical Association