ARTICLE SUMMARY:
Coding is a critical part of the device reimbursement process. Here Laurie McGraw, a leader of the AMA’s CPT coding group, addresses key issues for the medtech industry including transparency and delays in the process, the problems presented by Category III codes, and the lack of clarity concerning the doctrine of widespread use. The key takeaway: this isn’t your grandparents’ AMA and the organization is now actively promoting dialogue with industry.
Coding, coverage, and payment are the building blocks of the medical device reimbursement process, which is now generally viewed as the most significant challenge facing the medtech industry (along with financing, which remains a seemingly ever-present problem). Up until recently, a key element of that first component—the CPT (Current Procedural Terminology) coding procedure, which is run by the American Medical Association (AMA)—has been viewed by many industry executives and investors as a black hole, largely indecipherable from the outside and run by an organization generally seen as inaccessible and mired in tradition.
