Current Procedural Terminology (CPT) Coding and the Practice of Integrative Medicine

Coding for integrative medical services has a profound impact on serving the clients and constituencies that seek these services. Gaps in the Current Procedural Terminology (CPT) code set for complementary and alternative medicine (CAM) procedures are of significant concern. The comprehensive coverage and precision required for accurate communication of the provider/patient encounter is not available under the current CPT system. Lack of representation by certain licensed CAM professions on CPT panels and committees has been a factor. The ABC code set for CAM procedures developed by Alternative Link, Inc (“AltLink”), while an important effort to address this identified need, introduced a new set of concerns, including uncertain effects from coding integrative services through a separate code set. (1) There are significant gaps in available code sets that hinder the proper reporting, and indeed practice, of integrative and CAM therapies. (2) Difficulties in coding arise not merely from an absence of codes for many CAM procedures but from the guidelines, structure, and application of codes to health information infrastructure such as the determination of Relative Value Unit scales. (3) The development of codes that properly describe CAM services therefore requires representation by the professional associations whose members deliver this care.