Naturopathic Medicine CPT Codes: Categories & CPT Codes

An efficient coding system is an integral part of the healthcare industry. A coding system is crucial to store and retrieve a large amount of healthcare data, and to facilitate communication between different healthcare domains such as research, treatment, diagnosis, billing, insurance, and epidemiologic studies. CPT codes are used to report patient characteristics, evaluation, diagnostic, and treatment services by the healthcare providers in order to maintain the patient records and billing history of the healthcare provider. CPT codes are used by many medical specialties and subspecialties including complementary and alternative medical services. 

Naturopathic CPT Codes

Current Procedural Terminology or CPT codes were first developed by the American Medical Association (AMA) in 1966. CPT codes constitute level I of the Healthcare Common Procedure Coding System (HCPCS) whereas level II codes are formulated by the Centers for Medicare and Medicaid Services (CMS). The CPT codes are used to define and report almost all sorts of services provided by healthcare professionals. CPT codes are designed to reflect the duration of the procedure (examination, evaluation, and treatment), the type, and the complexity of the procedure performed as well as the mode of providing those healthcare services.

On the basis of payment eligibility, CPT codes are grouped into two columns. Level I codes are billed whereas the corresponding level 2 codes are not payable. Different modifiers are conjugated with the column I/column II CPT codes pair in order for both the codes to become eligible for billing. [1]

The CPT codes are further classified into three categories based on the purpose of use and the nature of services or procedures reported.

Codici CPT di categoria I are released once each year and are composed of 5 digits. These codes report the standard treatment procedures performed by qualified healthcare professionals. The medicines and technology used are approved by the US Food and Drug Administration. For instance, CPT code I 11102 is used for reporting tangential biopsy of the skin. 

Codici CPT di categoria II are to measure the quality of the procedures and services. Also called supplementary tracking codes, these are not compulsory to report. The category II CPT codes are made of four numbers followed by the letter F. For example, 3008F indicates the documentation of the body mass index (BMI). 

Lastly, category III CPT codes are referred to the advent of new technology, procedures, and medications that are yet to receive FDA clearance. The codes remain active for up to five years and are eliminated once the duration ends. If the codes are approved and validated by FDA and healthcare providers, they are added to category I of CPT codes. Category III codes are made of four numerals and the alphabet ‘T’ at the end. For instance, 0713T specifies noninvasive arterial plaque analysis. [2] 

Introduction to Naturopathic Medicine

Naturopathic medicine is a prevention-oriented form of alternative medicine that combines traditional and advanced healing techniques to maintain the overall wellbeing of an individual. Naturopathic medicine is based on three key principles – recognition of innate healing potential of the body, prevention of diseases, and emphasis on consuming a healthy and well-balanced diet. Naturopathic medicine identifies those factors which disrupt optimal health and reduce the exposure and effects of these factors on an individual’s health. The disease-causing factors may be:

1. Inborn – genetics, congenital abnormalities, maternal diet, lifestyle, maternal psychological state as well as exposure to harmful substances such as toxins, viruses, and certain drugs.
2. Nutritional Status and Lifestyle – psychological health, emotional health, environmental pollution, exposure to toxins, sedentary lifestyle, culture, social support, physical and emotional stressors.

The naturopathic doctors follow a sequence of interventions to restore health and eradicate the etiological determinants of the disease. The therapeutic order is mentioned below. [3]

Step 1: restore a healthy diet and lifestyle 

Step 2: stimulate innate healing mechanisms

Step 3: strengthen a weak healing system

Step 4: correct the physical structure of the body

Step 5: eliminate the pathology using natural substances or their derivatives 

Step 6: eliminate the pathology using synthetic medications and supplements 

Step 7: surgical correction of the underlying pathology 

CPT Codes for Naturopathic Medicine 

Congruent to the healthcare coding system, naturopathic medicine also employs CPT codes to record and bill for the services offered by naturopathic doctors. The CPT codes for naturopathic medicine are given in the table below. [4]

 Conclusione

CPT coding system, developed by the AMA, is extensively used in the healthcare departments for various reasons – maintaining records, billing services, validating insurance claims, and updating the epidemiological records for statistics. Naturopathic medicine is among the many healthcare subspecialties that use CPT codes for reporting its services. Naturopathic doctors apply a patient-centered approach to identify the determinants of disease and determine the plan of care to prevent the onset of diseases.  

Riferimenti

1. https://www.cms.gov/files/document/chapter1generalcorrectcodingpoliciesfinal11.pdf 
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/ 
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883816/ 
4. https://www.calnd.org/files/Patient%20letter%20for%20Insurance%20Companies%20Attachments%281%29.pdf