AMA’s critics unmoved by offer of free CPT code searches

AMA’s critics unmoved by offer of free CPT code searches – Exclusive Rights Under Fire

Joyce Frieden

Since February, the American Medical Association has been offering free searches of its online CPT coding manual, including listings of the amounts paid by Medicare for each service, to anyone who fills out its online registration form.

Users are limited to 10 searches per day. The AMA says that the new online service is mostly for patients who want to comparison shop for health care services.

“The AMA believes it is vital that patients have as much information as possible when making health care decisions, including an estimate of the costs,” Dr. Timothy Flaherty, who is chairman of the association, commented in a written statement.

“Nobody should put off reporting a condition or symptom to the physician because of the cost, but patients do have a right to know how much they or their insurers could end up paying,” he said.

The statement noted that the Web site “is intended to help patients in their personal research and is not meant to replace products developed by vendors for commercial and office use. For that reason, individuals are limited to 10 searches per day.”

The Association of American Physicians and Surgeons, long a vocal critic of the AMA’s exclusivity status regarding CPT codes, maintained that the AMA is simply trying to appease its critics.

“This is offensive public relations,” commented Kathryn Serkes. who is a spokesperson for the AAPS.

“They’re trying to look like good guys, placating us with piecemeal shreds of information,” she said.

Last July, Senate Minority Leader Trent Lott (R-Miss.) wrote a letter to Health and Human Services Secretary Tommy G. Thompson questioning whether the AMA should continue to have exclusive control over the CPT codes.

“By using its CPT copyright aggressively in court, the AMA has also been able to control who uses the codes and who knows what about the cost of doctor services,” Sen. Lott wrote. “The AMA’s proprietary interest in the CPT has also reportedly hampered efforts to educate doctors about proper practices in billing Medicaid, Medicare, and insurance companies.”

Sen. Lott also noted that the AMA’s proprietary use of the CPT code “stand[s] in stark contrast to the [ICD-9] code controlled and owned by [the government] itself, which is used by hospitals and others to bill Medicare and Medicaid for inpatient services. That code is copyrighted by the government, and is free to everyone.

As a result, hospital comparison prices are readily available, including on the Web, “and publishers can write books educating doctors and the general public on the proper use and meaning of the inpatient codes. And no one is being hauled into court for doing so.

Another force may have propelled the AMA’s decision to permit CPT code searches.

A lawsuit in the U.S. Court of Appeals for the 5th Circuit–Veeck vs. Southern Building Code Congress International Inc. — addresses the question of whether the building code congress can prohibit others from publishing its codes. The congress contracted with local governments to develop the codes that the governments require builders to use.

The decision in the case “is going to have a huge impact,” said Andrew schlafly, attorney for the AAPS, which filed a “friend of the court” brief in the case. “We expect that if the court holds that the building code association cannot own the [codes], likewise the AMA cannot own the [codes]. The AMA will lose its ownership [of the CPT codes].”

The AMA declined to comment on the building codes case as well as on its right to own the CPT.

But in its own amicus brief in the Veeck case, the association argued that losing the copyright to the codes would hurt both the organization and members of the public.

“Standards developers create and maintain at substantial expense their copyrighted codes [and] standards … and make them available to interested parties, government regulators, and the public at large,” the AMAs attorneys wrote.

“Loss of copyright protection for these works would drastically undermine the ability of standards developers to fund the ongoing creation and updating of these important works, and would therefore harm the governments and the public who benefit from and rely on the work of these standards developers.

Mr. Schlafly, who is based in New York, said at press time that he expected a decision soon in the case.

The AMA’s free CPT code lookup service can be found at https://webstore.ama-assn.org/index.html.

COPYRIGHT 2002 International Medical News Group

COPYRIGHT 2002 Gale Group