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Review
. 2022 Dec 3;5(1):177.
doi: 10.1038/s41746-022-00723-5.

Developing current procedural terminology codes that describe the work performed by machines

Richard A Frank  1   2 , Robert Jarrin  3   4 , Jordan Pritzker  3   5 , Michael D Abramoff  3   6   7 , Michael X Repka  3   8 , Pat D Baird  3   9 , S Marlene Grenon  3   10 , Megan Ruth Mahoney  3   11 , John E Mattison  3   12 , Ezequiel Silva 3rd  3   13   14
Affiliations
Review

Developing current procedural terminology codes that describe the work performed by machines

Richard A Frank et al. NPJ Digit Med. .

Abstract

The "Taxonomy of Artificial Intelligence for Medical Services and Procedures" became part of the Current Procedural Terminology (CPT®) code set effective January 1, 2022. It provides a framework for discrete and differentiable CPT codes which; are consistent with the features of the devices' output, characterize interaction between the device and the physician or other qualified health care professional, and foster appropriate payment. Descriptors include "Assistive", "Augmentative", and "Autonomous". As software increasingly augments the provision of medical services the taxonomy will foster consistent language in coding enabling patient, provider, and payer access to the benefits of innovation.

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Conflict of interest statement

R.A.F. reports the following competing interests: Principal, Frank Healthcare Advisors, LLC; member, CPT Editorial Panel. Sits on the Board of and is a minor shareholder in a Canadian innovator, Optina Diagnostics, which has no marketed products. Serves as Entrepreneur in Residence of DigitalDx Ventures I, L.P. Provides expert testimony to FDA, CMS, US Congress, WHO, IAEA, et alia. M.D.A. reports the following competing interests: Investor, Director, Consultant, Founder, Digital Diagnostics Inc; patents and patent applications assigned to the University of Iowa and Digital Diagnostics that are relevant to the subject matter of this manuscript; Chair Healthcare AI Coalition, Washington DC; member, American Academy of Ophthalmology (AAO) AI Committee; member. J.M. reports the following competing interests: Operating Partner and Chief Medical Information Officer of Arsenal Capital Partners which invests in companies that use AI to enhance clinical products and services. E.S. reports the following competing interests: Chair, RVS Update Committee (RUC). Other authors do not report financial and non-financial competing interests as defined by Nature Research, that might be perceived to influence the interpretation of the paper.

Figures

Fig. 1
Fig. 1. The continuum of AI CPT code descriptors.
Appendix S is intended to enable discrete and differentiable code descriptors by accurately characterizing the “work done by machines” relative to the work of the physician or other qualified health care professional. Therefore, these same descriptors may be useful also in regulatory labeling of novel products like “Software as a Medical Device” (SaMD) and in valuation, coverage and payment policy for the associated novel services or procedures, like “Software as a Service” (SaaS).
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References

    1. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann. Fam. Med. 2014;12:573–576. doi: 10.1370/afm.1713. - DOI - PMC - PubMed
    1. Board of Trustees. American Medical Association. Augmented intelligence (AI) in healthcare. Proceedings of the 2019 Annual Meeting of the American Medical Association. 138–158. https://www.ama-assn.org/system/files/2019-08/a19-bot-reports.pdf. Accessed April 14, 2022.
    1. CPT Editorial Panel. CPT appendix S: AI taxonomy for medical services and procedures. American Medical Association. January 1, 2022. https://www.ama-assn.org/practice-management/cpt/cpt-appendix-s-ai-taxon.... Accessed April 13, 2022.
    1. CPT overview and code approval. American Medical Association. https://www.ama-assn.org/practice-management/cpt/cpt-overview-and-code-a.... Accessed August 31, 2022
    1. Medicare physician payment schedules. American Medical Association. https://www.ama-assn.org/practice-management/medicare-medicaid/medicare-.... Accessed August 31, 2022.