ARTICLE SUMMARY:
The American Medical Association teamed up with Stanford Biodesign and Fogarty Innovation to present an in-depth look at the CPT coding process. Here are 10 key takeaways from that program that device companies need to be aware of to successfully obtain reimbursement and adoption of innovative technologies.
Of the three buckets that comprise medical device reimbursement—coding, coverage, and payment—perhaps the most inscrutable is coding, the linchpin of which are Current Procedural Terminology (CPT) codes. An ironic sign of the impenetrability of CPT codes is that while the acronym has become a common part of healthcare industry jargon, most people can’t remember what it stands for.
Until recently, a large part of that obscurity was attributable to the American Medical Association (AMA), the 175-year-old organization in charge of the CPT coding process. It was not keen on transparency, preferring to operate the system behind closed doors—another irony given that these codes were, from their inception, designed to promote a standard taxonomy to be used by all of the varied constituencies within the healthcare system. However, that appears to be changing. The AMA seems to be embracing a new level of transparency when it comes to the CPT coding process and, as part of that new openness, is actively reaching out to those constituencies to both share the inner workings of the CPT system and solicit suggestions as to how to improve the process. (See “A Look Inside the AMA’s CPT Coding Process: An Interview with Laurie McGraw,” Market Pathways, April 22, 2020 and “Solving Medtech CPT Coding Issues: Part 2 of an Interview with the AMA’s Laurie McGraw,” Market Pathways, May 26, 2020.)
