Code changes for all medical specialties take effect on January 1, 2018 as a result of the CPT Editorial Panel process. The American Medical Association (AMA) is responsible for Current Procedural Terminology (CPT) and has convened the CPT Editorial Panel to develop and maintain the nomenclature healthcare providers use to report medical procedures and services. The CPT Editorial Panel meets three times a year to evaluate code change proposals for new and emerging technology and is responsible for reorganizing and maintaining the code set. After codes are created or modified by the CPT Editorial Panel, they go before the Relative Value Update Committee (RUC), also convened by the AMA, to be valued. For more information on the RUC process and how to efficiently complete a RUC survey if you are randomly selected to do so, this 13-minute video prepared by the AMA is a good resource.
The CPT Editorial Panel and the RUC processes are cyclical; code changes approved by the CPT Editorial Panel at the February 2016 meeting, the May 2016 meeting, and the September/October 2016 meeting take effect on January 1, 2018. The Centers for Medicare and Medicaid Services (CMS) takes the RUC recommendations under consideration when assigning final values to codes and updates its payment policies annually via the Physician Fee Schedule rulemaking. The final rule setting code values and payment rates for 2018 was released by CMS on November 2, 2017.
ISASS joined the AMA’s House of Delegates in June 2014. With a seat in the House of Delegates came the opportunity to participate as advisors to the CPT Editorial Panel and the RUC beginning in calendar year 2015. ISASS strives to represent our membership in all three of these forums and provides this educational coding resource to our membership to prepare for spine coding in 2018 and beyond.
Click here for a look at what’s new in spine coding in 2018.
CPT codes and descriptions are copyright of the American Medical Association. All Rights Reserved.
The coding opinions referenced do not constitute legal advice. Every effort is made to ensure the accuracy of information provided, however, these opinions do not replace information contained in public or private payer policies or any published CPT material. The final decision for coding any procedure must be made by the surgeon, considering regulations of insurance carriers and any local, state or federal laws that apply to the surgeon’s practice. ISASS nor any of its officers, directors, agents, employees, committee members or other representatives shall have any responsibility or liability for any claim, including but not limited to any claims for costs, legal fees, Medicare or insurance fraud, arising from the use of these opinions.