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.”▪
