Dynamic Chiropractic – July 1, 2011, Vol. 29, Issue 14

When a DC Meets CPT – Codes, That Is

Dr. Anthony Hamm elected co-chair of AMA review board.

By Editorial Staff

Unless you've been hiding under a rock for the past decade, you know all too well the perpetual frustrations caused by the Resource-Based Relative Value Scale, which is used to determine annual Medicare reimbursement rates.

Every year, the scale seems to mandate reductions in the rate of reimbursement, and every year, congressional intervention – usually at the 11th, if not 12th hour – is required to prevent the cuts from taking effect. (For the latest example of this, read "Medicare Fee Cuts Delayed Another Year; 2.2 Percent Fee Increase Stays in Effect Until 2012" in the Jan. 15, 2011 issue.)

The American Medical Association's Relative Value Scale Update Committee (RUC) makes annual recommendations on relative values for CPT codes and performs five-year reviews of the Resource-Based Relative Value Scale. How will a doctor of chiropractic's presence on the committee impact future value determinations?

Enter Anthony Hamm, DC, FACO, president of the American Chiropractic Association's Council of Delegates and newly elected co-chair of the AMA's Health Care Professionals Advisory Committee Review Board (HCPAC). Dr. Hamm becomes the first doctor of chiropractic elected to the position, which takes effect in September.

According to the ACA, the review board "develops recommendations on relative values for new and revised CPT codes for non-MD/DO services." Dr. Hamm will also serve on the RUC, meaning that his input and expertise could play a large role in determining future rates of Medicare reimbursement.

"[The] ACA strongly supported Dr. Hamm's nomination to this position given his clinical and socioeconomic experience and expertise in making appropriate recommendations for CPT codes across specialties," said ACA President Rick McMichael, DC. "This historic event is consistent with the ACA's commitment to the delivery of high- \quality patient care by doctors of chiropractic within multidisciplinary practice settings."

Dr. Hamm's extensive background in reimbursement issues includes serving as the chiropractic consultant to the HCPAC / RUC; contributing to the ACA's Chiropractic Coding and Compliance Manual; and nearly a decade of experience teaching coding, documentation, Medicare and risk management to the chiropractic profession.


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