If the original requestors of the code want to continue use of the code, they must submit a proposal for continuing the code as a Category III code or promoting it to Category I status. Because it is difficult to imagine why the fate of an emerging technology would not be clear within 5 years, no Category III code has been renewed for a second 5-year term.
Category III codes are important for maintaining the integrity of the CPT process, since they permit a means to track the use of new technology, before such technology is widely adopted. The use of similar Category I codes for new technology is clearly discouraged by the CPT rules; in fact, the rules, in their strictest sense, actually prohibit this.
The other alternative is the use of unlisted procedure Category I code, but when physicians do this, it becomes impossible to measure the actual usage of a specific technology. Thus, the preferred route for coding new technology is the development and application of a Category III code. CPT has evolved since its introduction, and the AMA has a specific process for monitoring the integrity of CPT and adapting for changes in physician practice and medical technology.
In general, such codes report services whose effectiveness is well supported in the medical literature and whose constituent parts have received clearance from the US Food and Drug Administration FDA.
The concept is that the use of these codes should facilitate the administration of quality improvement projects by allowing for standardized reporting that captures the performance or non-performance of services designated as subject to process improvement efforts. If you look at it says " may be reported in conjunction with , , FTessaBartels Guest.
I disagree - CPT is correct I'm just guessing here, because there are SO many inconsistencies in the new pediatric codes. I really think AMA needed someone who is an English major to clearly write these descriptions and edit for inconsistencies. I think the only part of the parenthetical remark under that is incorrect is saying you cannot use it with or Then again, under the Newborn Care Services paragraph CPT professional edition, pg 32 it states in the 3rd paragraph When delivery room attendance services or delivery room resuscitation services are required, report these in addition to normal newborn services.
That's clear as mud! There's an audio conference on Wednesday Dec 3 on the new pediatric codes. I plan to ask a LOT of questions! Yeah it is a total mess. One thing says it one way then the total opposite in another place.
Makes me laugh. Let us know what they say about it in the audio conference. Im curious to know! It is included in the exam component of the service reported. Editor's note: While this department attempts to provide accurate, useful information, some payers may not agree with the advice given. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more.
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