Adoption of CPT Code Set Key to Success
Nicosia, Cyprus, June 24, 2020 (GLOBE NEWSWIRE) — The Health Insurance Organisation (HIO) and the American Medical Association (AMA) marked the one year anniversary of the adoption of the Current Procedural Terminology (CPT®) and the significant health care progress that the medical code set has enabled in the last year.
An agreement with the AMA provided the HIO a license to use CPT content, a comprehensive, leading-edge code set developed by the AMA that identifies and describes more than 10,000 medical services and procedures. Since the agreement, the HIO has been using CPT to improve standardization and data quality. This has an important impact not only on the HIO’s ability to track data, but also impacts claims management as well. To reduce the incidence of incorrect coding, HIO has built medical rules that encourage proper coding while also making it easier to limit deviations and improper use. This improves the integrity of the entire system. The one-year anniversary has also given the HIO enough time to extract meaningful data to drive policy and further support the evolution of the healthcare system.
Following the initial launch of the General Healthcare System in Cyprus and the adoption of CPT as a code set for the purposes of outpatient specialists activities, the HIO has been identifying through claims management trends and patterns on the services provided to GHS beneficiaries. Data reported by the CPT code has helped guide policy making. More specifically, guidelines are being issued to healthcare providers as a measure to promote better healthcare quality, correct coding but also to control costs and define coverage of services.
Furthermore, HIO has set up a separate department to manage activity catalogues and interact with scientific societies in order to refine existing catalogues as a means of achieving ongoing improvement.
HIO was established for the implementation and administration of the GHS, a patient-centric healthcare system based on social solidarity that achieves universal coverage of the population, equal treatment of all beneficiaries, provision of a comprehensive package of healthcare services and freedom of choice of provider by beneficiaries.
HIO administers a special GHS fund from which all payments are made to compensate healthcare providers for the provision of healthcare services to GHS beneficiaries. CPT codes are used to identify the specific treatments and procedures provided to patients by Outpatient specialists and streamlines the reporting of this information to HIO for review and payment.
CPT content serves the needs of data-driven health systems by allowing healthcare providers and payor organizations to easily exchange unprecedented amounts of standardized data on the medical services and procedures provided to patients. This seamless flow of information facilitates reporting, measuring, analyzing, researching, and benchmarking of medical services and procedures with the goal of delivering better patient care, better outcomes and lower costs.
“For over fifty years, CPT has served the needs of integrated health delivery systems that need efficient and effective data exchange to help improve cost, quality, and access to care,” said AMA President-elect Gerald E. Harmon, M.D. “As a uniform and rigorous code set, CPT is widely trusted as medicine’s universal language for reporting medical services and procedures provided to patients.“
Medical knowledge and science are constantly advancing, so the CPT Editorial Panel manages an extensive process to make sure the CPT code set advances with it. The Panel obtains broad input from practicing physicians and the health care community to ensure that the CPT code set reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous process keeps the CPT code set current with contemporary medical science and technology, so it can fulfill its vital role as the language of medicine today and the code to its future.
Constantinos Panayides Health Insurance Organisation +357 22557200 c.panayides@hio.org.cy Robert J. Mills American Medical Association +1-312-464-5970 robert.mills@ama-assn.org