Pediatric Coding Alert

Question: Does our practice need to make any changes to our systems to accommodate the fact that CPT^® 2013 changed so many descriptors from "physician" to "other qualified health care provider?"

Answer: The most widespread changes throughout CPT^® 2013 -- the switch to more inclusive or provider-neutral language -- shouldn’t be difficult for physician practices to put into place.

"The concepts are pretty straightforward," said Richard Duszak, Jr., MD, an AMA CPT^® Editorial Panel member and practicing radiologist, during his presentation at the American Medical Association’s (AMA) annual CPT^® and RBRVS Symposium, held Nov. 14-16 in Chicago. "There’s been an evolution in CPT^® for how codes report services by non-physicians."

Result: Hundreds of codes were revised for 2013 to include "provider neutral language." Codes throughout the book have replaced designations of "physician" with "individual" or "qualified health care provider."

Exception: A few codes retained the "physician" language, such as those related to skilled nursing facility admissions, because regulations require that a physician admit the patient.

"CPT^® is not the turf police," Duszak said. "We’re focusing on the services provided and recognize that sometimes professionals other than physicians are qualified to provide some services. As a nationally recognized reporting system, it’s important for CPT^® to maintain provider neutrality."