Psychiatric News August 19, 2005
Volume 40 Number 16
© 2005 American Psychiatric Association
p. 5
Psychiatrist Reappointed Chair Of CPT Editorial Panel
Mark Moran
The AMA first developed codes for medical services and collected them in
a manual called Current Procedural Terminology. Eventually the
insurance industry and federal government adopted them.
Psychiatrist Tracy Gordy, M.D., was reappointed by the AMA to a second term
as chair of its Current Procedural Terminology (CPT) Editorial
Panel.
The panel is responsible for maintaining and updating the manual of codes
to which are attached descriptions of every kind of procedure that a physician
may perform. The purpose of CPT is to provide a uniform language that
accurately describes medical, surgical, and diagnostic services and thereby
serves as an effective means for reliable nationwide communication among
physicians, other health care providers, patients, and third-party payers,
according to the AMA.
The codes are used for reimbursement by the insurance industry, but also
for statistical and research purposes: health services researchers, for
instance, may seek information on how many codes for a particular service have
been submitted in a defined period of time.
As chair and the only psychiatrist on the panel, Gordy occupies a strategic
position. "All of medicine looks to the panel if they have a new
procedure," Gordy told Psychiatric News. "It is the body
that is going to grant them a code that they will use to indicate a specific
service or procedure has been performed."
Professional societies such as APA, individual physicians, and
manufacturers of devices may submit procedures to the board for review. Gordy
said that several hundred procedures are submitted every year and that
anywhere from 80 to 100 "category 1" codes—codes that are
specifically used for reimbursement—may be approved.
Codes for new services related to treatment of mental illness, such as
vagus nerve stimulation, are in the works for approval, Gordy said.
The CPT was first developed by AMA as a descriptor of services in
1966. In time, the codes were adopted by the insurance industry, and in the
1980s the federal government adopted the codes for use in reimbursing services
under Medicare.
The panel, which will meet three times this year, has 17 members. Of these,
11 are physicians nominated by the AMA Board of Trustees; other members of the
board are nominated by the Blue Cross and Blue Shield Association, the Health
Insurance Association of America, the American Hospital Association, and the
Centers for Medicare and Medicaid Services.
Gordy has been on the CPT Editorial Panel for 15 years and has
been chair for the last six. Recently retired from private practice in Austin,
Texas, he continues to serve as a consultant to the Social Security
Administration, testifying as a psychiatric expert for the Social Security
Administration's Office of Hearings and Appeals. Along with psychiatrist
Chester Schmidt, M.D., Gordy also conducts consultations to educate APA
members and others about coding and documentation issues.
"I have thoroughly enjoyed my time with the panel," Gordy said.
"Those of us who serve on the panel take off our specialty hats and
review all kinds of things. It's like going back to medical school."
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