Comment

Current Procedural Terminology (CPT) code set be added

The American Medical Association (AMA) requests that the Current Procedural Terminology (CPT) code set be added to the standards listed in Section I: Representing Physical Activity. Currently a two-question screening tool in LOINC is listed as the standard for this interoperability need. The CPT code set can convey additional information about a patient’s physical activity. Specifically, codes for physical and occupational therapy evaluations identify a change in a patient’s activity status. The evaluation and plan of care for a person undergoing physical or occupational therapy are critical to returning them to their former level of physical activity or their new optimal level. Changes in a person’s physical activity can have a significant effect on their social and psychological well-being, and, therefore, are important to convey through care coordination with other providers. Other CPT codes related to physical activity include ones for athletic training evaluations, therapeutic procedures to improve physical function, orthotic management and training and prosthetic training, and tests and measurements of physical performance.

 

CPT is a comprehensive and regularly curated uniform language that accurately describes medical, surgical, and diagnostic services and provides reliable communication among users. It has an extremely robust and mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders.

The AMA requests that the…

The AMA requests that the Current Procedural Terminology (CPT) code set be added to the standards listed in Section I: Representing Physical Activity. Physical activity is identified in the Physical Therapy Evaluations codes, 97161 – 97164, and Occupational Therapy Evaluations codes, 97165 – 97167. CPT codes 97169 – 97172 identify athletic training evaluations, which includes a physical activity profile. The CPT Evaluation and Maintenance services include assessing a patient’s level of physical activity. CPT codes 97750 and 97755 identify tests and measurements of physical performance.

In addition, CPT Category II code 1003F identifies an assessment of patient level of activity.

CPT is a comprehensive and regularly curated uniform language that accurately describes medical, surgical, and diagnostic services and provides for reliable communication among users. It has an extremely robust and mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders. It is the most widely adopted outpatient procedure code set. Use of the CPT code set is federally required under HIPAA.

Since this LOINC code and…

Since this LOINC code and answer set has been developed (30 behavior and functional status variables suggested by the IOM report and adopted for requirement in the last MU NPRM), the adoption level could now be very high.

Regenstrief - Comment

Although there are many ways to record or observe physical activity, we agree that LOINC is the appropriate terminology for these observations and that the “exercise vital sign” screen is a good starting place.

In version 2.64, LOINC published a slightly updated panel (89574-8) for the EVS that reflects Kaiser Permanente’s conceptualization of these screening observations. The two child elements in this panel are 89555-7 and 68516-4.