With the RUC's development of the new CPT manual still underway, a a group called the chiropractic committee for the draft document, chaired by Sid Williams, BS, DC, founder and president of Life College, has just released a comprehensive document, CPDT-1'96 Chiropractic Procedural & Diagnostic Terminology. It is a first edition work and is being circulated for the chiropractic profession's review.
"Both medical and dental professions have developed code manuals to accurately report their particular services to third party payers and health organizations," explained Dr. Sid Williams. "A similar document for the description of chiropractic services is long overdue. For this reason we have agreed to provide a comprehensive guide of chiropractic services and diagnoses to the health and insurance organizations."
Dr. Williams asserts that the document will accelerate claim processing, and better manage raising health care costs. "Our profession cannot make real progress toward acceptance and recognition until business, the other professions, legislators, and the general public are aware of the clinical applications of chiropractic science."
The need for chiropractic procedural and diagnostic codes is clear. "If there has been one inadequacy in our presentation as a unique health profession, it has been in our communication of what we clinically do," said Dr. Williams.
Compensation for DCs under the medical rubric has been narrowly defined by the International Classification of Diseases codes (ICD-9), and the physical medicine section of the AMA's Current Procedural Terminology codes (CPT-4). Dr. Williams pointed to chiropractic's primary worry: "Our profession should be concerned that the continued utilization of these codes designed by the AMA eventually may result in efforts to preclude chiropractors from caring for patients who suffer from a broad spectrum of health problems."
The CPDT-1'96 codes are broken into procedural (CPC-1) and diagnostic codes (CDC-1): There are seven categories under procedures and services:
- evaluation and management
- radiographic studies
- chiropractic care visits
- reconstructive and rehabilitative counseling programs
- wellness counseling programs
- additional diagnostic studies
- additional services
There are six categories under diagnostic codes:
- vertebral subluxations and other structural distortions
- complicating biomechanical factors
- associated neurological factors
- related soft tissue factors
- concomitant visceral factors
- aggravating occupational/environmental/life-style factors
The consensus plan of the committee for the draft document calls for a council with representatives from major chiropractic organizations to receive input from an advisory board for use in editing and publishing the final document. The board is planning to have representatives from all major chiropractic organizations:
- Federation of Chiropractic Licensing Boards
- accredited chiropractic colleges
- state licensing boards
- national and state organizations
- World Federation of Chiropractic
The board's additional representation will come from the health insurance industry, third-party payers, and the council.
All practicing DCs are welcome to attend advisory board meetings as observers. Suggestions also will be solicited from the field and forwarded to the council. A consulting group comprised of doctors of chiropractic will be appointed to assist the advisory board in collecting and evaluating information relevant to coding changes and improvements. The names of these consultants will be published as contributors to this historic document and process. Practicing chiropractors are welcome to attend the final consensus meeting as observers.
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