Implementation Framework

The American Medical Association developed the Current Procedural Terminology (CPT®) Implementation Framework to support the understanding and successful adoption of CPT content. The downloadable Educational Handbook that explains the Framework is a resource to assist all audiences -- including leaders, teams, and individuals. The contents of the Educational Handbook was developed to decrease the complexity and work effort required to implement the CPT code set. It identifies and supports consistent, reusable documentation, processes, and technical requirements related to all organizations.

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The CPT Implementation Framework Educational Handbook consists of 12 components 

Component 1: Framework

Component 1: Framework - gives an overview of the CPT content uses, their implementation considerations and risks; describes the CPT content implementation components, the key blocks of work involved in each one, and how they form a cohesive unit recognizing linkages and dependencies

Component 2: Current Procedural Terminology (CPT®) Primer

Component 2: Current Procedural Terminology (CPT®) Primer – supplies what is needed to understand CPT content, eg, what is CPT content, what are the benefits of adopting CPT content, reasons for wanting to investigate CPT content, and how does CPT content compare to other terminologies and classifications

Component 3: Assessment of Feasibility

Component 3: Assessment of Feasibility – defines the steps to complete an assessment of feasibility to determine if CPT content is suitable for clinical service reporting

Component 4: Licensing

Component 4: Licensing – AMA CPT Licensing overview information at https://www.ama-assn.org/practice-management/cpt/ama-cpt-licensing-overview

Component 5: Mapping

Component 5: Mapping – stipulates the step-by-step mapping process to follow and tools needed to effectively map frequently used local terms to CPT terms; includes a sample map

Component 6: Subsets

Component 6: Subsets – delivers a method for developing and maintaining CPT clinician descriptor physician specialty local/national subsets; includes examples of a subset and supporting technical files

Component 7: Clinical Reporting

Component 7: Clinical Reporting – describes the supporting CPT content available as clinical reporting guidance

Component 8: CPT® Link

Component 8: CPT® Link – explains the content contained within CPT® Link and how it relates to the CPT® 2021 Professional Edition (or other edition) book and describes how to query CPT® Link when it has been imported into a database

Component 9: Technical Functional Requirements

Component 9: Technical Functional Requirements – outlines vendor (claims administrators, EMR companies, billing firms) requirements for CPT content implementation

Component 10: Educational Materials

Component 10: Educational Materials – identifies AMA product education offerings relevant for implementation of CPT content by physicians, billing clerks, clinical data users, and how to obtain

Component 11: Terminology Management

Component 11: Terminology Management – furnishes guidance on how CPT content management can most efficiently be done and implemented

Component 12: Resource-Based Relative Value Scale (RBRVS)

Component 12: Resource-Based Relative Value Scale (RBRVS) – summarizes the relative value system, the role of the AMA/Specialty Society RVS Update Committee (RUC), the connection to CPT content, and describes uses of relativity measures

Glossary

Implementation Guide Disclaimer. Information provided by the American Medical Association (AMA) in this Implementation Guide is for educational and informational purposes only. This Implementation Guide does not supersede or replace the AMA’s Current Procedural Terminology (CPT®) book or other coding authority, does not constitute clinical advice, does not address or dictate payer coverage or reimbursement policy, and does not substitute for the professional judgement of a practitioner performing a procedure, who remains responsible for correct coding.

You acknowledge that you may use the Implementation Guide and its components for your personal, non-commercial use. You are responsible for securing any necessary rights to use copyrighted works for any other use. This Implementation Guide should not be construed as granting permission for you to create derivative works of CPT content, including translations, maps, linkages, and subsets of CPT codes and descriptions. Such activities are expressly prohibited unless authorized under a license agreement.

The AMA makes no copyright claim to government data that is in the public domain. 

While every effort was made to be complete and accurate when this Implementation Guide was created, the information in this Implementation Guide is provided “AS IS” without warranty of any kind, either express or implied. The AMA disclaims responsibility for any errors or omissions in the Implementation Guide and for any consequences attributable to or related to any use, reliance, or interpretation of the content and information in this Implementation Guide.

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