Here’s how to cultivate equity in the CPT code set landscape

Andis Robeznieks , Senior News Writer

Moving Medicine

Cultivating equity in the CPT landscape, with Barbara Levy, MD

Dec 16, 2022

Whether it’s in efforts to remove stigma or to advance health equity, physicians and health professionals are often told that “language matters.” This same concept applies to the Current Procedural Terminology (CPT®) code set, often referred to as the “language of medicine.”

Advancing health equity requires addressing CPT, said participants in an episode of the “AMA Moving Medicine” podcast.

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The AMA strategic plan to embed racial justice and advance health equity calls for embedding equity in practice, process, action and innovation, and ensuring equity in access to innovation for populations and communities that, historically, have not shared in the benefits of new health care technology and procedures.

This includes embedding equity into the development of new CPT codes used to organize and describe innovations physicians incorporate into their practices.

Efforts are underway to add new people to the process and to ensure the evidence used to validate these innovations includes the experiences and knowledge of an inclusive patient population, including patients most impacted by health inequities.

“As we are looking at code descriptors and we're looking at the literature to support codes, equity is always in the back of my mind,” said AMA member Barbara Levy, MD, vice chair of the AMA CPT Editorial Panel and former chair of the AMA/Specialty Society RVS Update Committee (RUC).

Dr. Levy explained that this includes asking questions such as:

  • What was the patient population studied?
  • Does the code descriptor adequately help physicians and qualified health care professionals understand what the literature supports—and what it doesn't support—with respect to the patient population?

Such questions represent “a new way of looking at things, but in my mind a randomized clinical trial is only as good as the people that are involved in the trial,” said Dr. Levy, a clinical professor of obstetrics and gynecology at George Washington University School of Medicine & Health Sciences, as well as University of California, San Diego Health.

If a clinical trial’s participants “are all white and male, then it's very hard to apply that intervention, service, procedure—whatever it is—to my patients who are all female, or to people in other populations,” she added.

When new codes are proposed, Dr. Levy said the CPT Editorial Panel should be thinking about the criteria used to establish new codes and request that applicants provide information on the populations that were studied and for whom a new procedure is intended.

Inviting new voices to be heard

The CPT process is not “etched in concrete,” Dr. Levy said, and she invited all interested physicians—especially those who have felt disenfranchised—to get involved in the curation of the code set.

“It's a totally open process and we are hungry to hear their voices,” she said, adding that it was critical to ensure “that the code set is inclusive and representative of the work that all of us do.”

The AMA is advancing equity at the system and organizational levels to ensure all people have the power, conditions, resources to achieve optimal health.

The “AMA Moving Medicine” podcast spotlights current issues in medical innovation and public health. In this medical podcast, find episodes featuring interviews with physicians, educational presentations from medical professionals and more.

Listen to Moving Medicine on Apple podcasts, Spotify, or wherever you get your podcasts.