The American Medical Association (AMA) has established an editorial board for the CPT ® Assistant newsletter. The CPT ® Assistant Editorial Board will give specialty societies, payers, and other CPT stakeholders the opportunity for formal input into the process of selecting topics for articles, reviewing the publication's coding content, and contributing content for publication.
Background
In 2004, the AMA's Board of Trustees responded to an AMA House of Delegates Resolution that called on the AMA to study the feasibility of developing a national standard for the utilization of codes, code combination, and modifiers that is consistent with all CPT codes, guidelines, and conventions and that would be used by all commercial and governmental payers. Shortly after the 2004 Annual Meeting, the AMA contracted with an external consulting group that specializes in evaluating and designing legislative and regulatory proposals, developing and analyzing options to achieve the strategic goals of its clients, drafting legislation, and developing ideas on a wide array of health policy and related areas.
A study was conducted based on a review of a wide range of written documents and on-line reference materials. It was also based on more than two dozen structured interviews with representatives of key stakeholders in the CPT coding community and other individuals with relevant expertise and experience. These individuals included:
Representatives of the CPT Editorial Panel, the CPT Advisory Committee, the Health Care Professionals Advisory Committee (HCPAC), and the AMA/Specialty Society RVS Update Committee (RUC)
Physician and staff representatives of national medical specialty societies, state medical associations, and national organizations representing nonphysician health professionals
Representatives of hospitals, professional coders, and coding consultants
Representatives of the Centers for Medicare and Medicaid Services (CMS), Medicare contractors, the National Center for Health Statistics (NCHS), the National Committee on Vital and Health Statistics, and other agencies within Health and Human Services
Physician and staff representatives of health insurance companies and managed care organizations and the national associations representing their interests
Individuals knowledgeable about proprietary claims editing programs
The New Board
After reviewing the report recommendations, it was decided that the AMA should move forward with the creation of an editorial board. The board represents a departure from the past 17 years, during which the newsletter was primarily a product of AMA staff with CPT Editorial Panel and/or CPT Advisory Committee review of content. In the past, the focus and purpose of the CPT ® Assistant was to impart coding advice from the AMA perspective based on discussion of the use and interpretation of the codes at panel meetings and as reflected in the official Panel minutes. With the creation of the editorial board, the focus of the newsletter will subtly shift from providing strict CPT coding guidance and interpretation to responding to “real world” coding issues.
Formal input from key stakeholders will:
- Give the publication even greater standing among public and private payers
- Make for a much more dynamic publication by being alerted to problem coding issues and responding quickly with articles or
clarifications - Provide an educational vehicle for attempting to reduce conflict between physicians and third-party payers and resolve differences of opinion among various CPT stakeholders
CPT ® Assistant Editorial Board Composition
The composition of the CPT ® Assistant Editorial Board is consistent with the reorientation of the CPT ® Assistant newsletter and includes public and private payers, as well as multispecialty physician and nonphysician representation. The current CPT ® Assistant editorial staff and the CPT Advisory committee will continue to play their same vital roles in article composition, review, and commenting by ensuring that the content accurately represents CPT guidelines. The CPT ® Assistant Editorial Board will serve as an adjunct body to the current editorial process.
The CPT ® Assistant Editorial Board composition is as follows:
Chair: William Thorwarth, MD
Vice Chair, CPT Editorial Panel
J. Martin Tucker, MD
CPT Editorial Panel
Peter A. Hollmann, MD
CPT Editorial Panel
Albert Bothe, Jr, MD
CPT Advisory Committee
Richard A. Molteni, MD
CPT Advisory Committee
Helene M. Fearon, PT
Health Care Professionals Advisory Committee (HCPAC)
Charles F. Koopman, Jr, MD
AMA/Specialty RVS Update Committee (RUC)
Kenneth B. Simon, MD, MBA
Centers for Medicare and Medicaid Services
Richard W. Whitten, MD, MBA
Contractor Medical Director
Claudia J. Bonnell, RN
Blue Cross Blue Shield Association
Gerald E. Silverstein,MD
America 's Health Insurance Plans
Nelly Leon-Chisen, RHIA
American Hospital Association
AMA staff serving as board representatives include:
Secretary: Dan Reyes, Managing Editor, CPT ® Assistant
Director of CPT Product Development
Danielle Pavloski, Director, CPT Information and Education Services
Lianne Stancik, CPT Senior Coding Specialist
The establishment of an editorial board for the CPT ® Assistant sets the groundwork for the newsletter to evolve into a multipurpose publication: high level AMA coding guidance from the perspective of the CPT ® Editorial Panel and practical coding advice based on input from payers and other coding experts. The editorial board will be charged with the challenging task of balancing AMA interpretation and “real world” coding practices. It is critical that the CPT ® Assistant evolve to meet this demand without losing its identity as the AMA's official interpretation of CPT coding practices.
The first meeting of the board was held on Wednesday, Feb. 7, 2007, in San Diego, California, in coordination with the CPT Editorial Panel Meeting.
Note: This article has been slightly revised from the form that originally appeared in the February 2007 CPT ® Assistant.
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Content provided by: CPT Editorial & Info Services