Re: [openhealth] Re: list of diagnoses and procedures

[Rod Roark]

A lot depends on the desired goal.

If you take the point of view that the government's allowing the AMA
to rake in undeserved millions via this monopoly is just plain wrong,
and you want to do something about it, then creating a community
project to define different but compatible codes and descriptions is
surely bound to shine a spotlight on the issue and lead to some
changes.  By applying the previously-mentioned KISS principle, doing
this should be relatively easy.

Even absent the political ramifications, the resulting new system
will have useful applications.  A billing service accepting the new
codes would still need CPT licensing, but individual practitioners
subscribing to such a service would not.  It doesn't take much thought
to see how this might play out.

Rod
www.sunsetsystems.com

On Monday 11 December 2006 11:56, David Forslund wrote:
> I agree. I don't think you would have to declare them something
> other than CPT codes even if they had the same number.  With
> a different description, they couldn't be certified as the same and
> wouldn't come under the legal agreement of CMS (HCFA). 
> I think it would be nice to have alternative to CPT, but this would
> require more than coming up with code descriptions.  It would require
> calling it something else and entering into agreements with CMS and
> other organizations including states.  This is not a free exercise.
> 
> Dave
> Fred Trotter wrote:
> >
> > I dont think so. From what I understood the codes themselves are 
> > copyright.
> > Further, thier use is mandated by the government for use in medical 
> > billing.
> > This issue has already been the subject of litigation.
> >
> > http://www.usdoj.gov/atr/cases/f2000/2076.htm 
> > 
> >
> > -FT
> >
> > On 12/11/06, mspohr <[EMAIL PROTECTED] > wrote:
> > >
> > > The codes would be the same as those that they currently accept (i.e.
> > > the AMA CPT codes) so there is no issue with the codes.
> > > The problem with the AMA is that they copyright the descriptions and
> > > prevent distribution of their copyrighted descriptions.
> > > The project would be to create new descriptions that were functionally
> > > the same and could be freely distributed under an open license such as
> > > the Creative Commons license (http://creativecommons.org/ 
> > ).
> > >
> > > /Mark
> > >
> > >
> > >
> > > --- In openhealth@yahoogroups.com 
> > , David Forslund <[EMAIL PROTECTED]> 
> > wrote:
> > > >
> > > > This effort would require commitment from the payor that they
> > > > would accept those codes for reimbursement. Otherwise this
> > > > effort will be relatively useless.
> > > >
> > > > Dave
> > > > mspohr wrote:
> > > > >
> > > > > The goal of the CPT code project would be to create a version of
> > > > > procedure codes for use in billing in the US that could be freely
> > > > > distributed.
> > > > > While it would be nice to fit this into an overarching ontology, 
> > this
> > > > > would introduce overhead which is not warranted. The CPT codes
> > > > > themselves are a dead end (except for billing in the US) from both
> > > > > intellectual property and information design standpoints and the 
> > task
> > > > > of an ontology of procedures is better left to something more 
> > suitable
> > > > > such as Snomed or ICD or even the HCPCS.
> > > > >
> > > > > I think KISS applies here.
> > > > >
> > > > > /Mark
> > > > >
> > > > > --- In openhealth@yahoogroups.com 
> > 
> > > > > , Adrian Midgley 
> > > > > wrote:
> > > > > >
> > > > > > Rod Roark wrote:
> > > > > > >
> > > > > > >
> > > > > > > Perhaps I don't understand what you mean, but CPT codes are
> > > just for
> > > > > > > procedures. The project I was suggesting was limited to
> > > restating the
> > > > > > > descriptions for them, with about the same standards for
> > > preciseness
> > > > > > > currently found in CPT. A broader scope would be very daunting.
> > > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > > But if we are going to do (an) ontology, let us not handicap
> > > ourselves
> > > > > > by building it for just one lot of data. It could be written one
> > > > > > chapter at a time, certainly.

Re: [openhealth] Re: list of diagnoses and procedures

[Adrian Midgley]

Fred Trotter wrote:
>
> It is easy at first glance to think that way. Consider the other side
> of the
> equation. The AMA worked for a long time to create accurate procedure and
> diagonsis codes. The goverment choose the AMAs coding scheme for
> reimbursement. But the government cannot simply take a private companies
> copyright and make it public domain;
>







Thus, in order to end up with a system whcih is Libre, first write a new
system.

RE: [openhealth] Re: list of diagnoses and procedures

[John H. bergman]

At what point does some, or all of the copyrighted material become
public domain?  Patents have a life span of what? 10 years... copyrights
also have a lifespan... 

 



From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of Fred Trotter
Sent: Monday, December 11, 2006 8:20 PM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Re: list of diagnoses and procedures

 

It is easy at first glance to think that way. Consider the other side of
the
equation. The AMA worked for a long time to create accurate procedure
and
diagonsis codes. The goverment choose the AMAs coding scheme for
reimbursement. But the government cannot simply take a private companies
copyright and make it public domain; the AMA owns the copyright. The
court
held that as long as the license fees were not onerous there was nothing
that could be done. As a result we have this "elvish" situation.

This is actually one unique subset on the problem of "owning ideas".
Software Patents and proprietary software are other examples of this
problem.

Hopefully future work will have a more FOSS-compatible perspective.

-FT

Regards,
Fred Trotter

On 12/11/06, K.S. Bhaskar <[EMAIL PROTECTED]
 > wrote:
>
> I find this discussion of CPT codes & reimbursement interesting. Let
me
> paraphrase:
>
> "To petition your Government (for reimbursement), you need to submit
> your request in Elvish. Organization XYZ owns the Elvish language.
> Ergo, to communicate with your Government, you need to buy a license
> from XYZ to use Elvish."
>
> This seems quite an incredible state of affairs.
>
> -- Bhaskar
>
>
>
> Yahoo! Groups Links
>
>
>
>

-- 
Fred Trotter
http://www.fredtrotter.com  

[Non-text portions of this message have been removed]

 



[Non-text portions of this message have been removed]

Re: [openhealth] Re: list of diagnoses and procedures

[Fred Trotter]

It is easy at first glance to think that way. Consider the other side of the
equation. The AMA worked for a long time to create accurate procedure and
diagonsis codes. The goverment choose the AMAs coding scheme for
reimbursement. But the government cannot simply take a private companies
copyright and make it public domain; the AMA owns the copyright. The court
held that as long as the license fees were not onerous there was nothing
that could be done. As a result we have this "elvish" situation.

This is actually one unique subset on the problem of "owning ideas".
Software Patents and proprietary software are other examples of this
problem.

Hopefully future work will have a more FOSS-compatible perspective.

-FT

Regards,
Fred Trotter

On 12/11/06, K.S. Bhaskar <[EMAIL PROTECTED]> wrote:
>
> I find this discussion of CPT codes & reimbursement interesting.  Let me
> paraphrase:
>
> "To petition your Government (for reimbursement), you need to submit
> your request in Elvish.  Organization XYZ owns the Elvish language.
> Ergo, to communicate with your Government, you need to buy a license
> from XYZ to use Elvish."
>
> This seems quite an incredible state of affairs.
>
> -- Bhaskar
>
>
>
> Yahoo! Groups Links
>
>
>
>


-- 
Fred Trotter
http://www.fredtrotter.com


[Non-text portions of this message have been removed]

Re: [openhealth] Re: list of diagnoses and procedures

[Karsten Hilbert]

On Mon, Dec 11, 2006 at 02:16:32PM -0700, David Forslund wrote:

> I think the issue is bigger than that.  The AMA has a legal agreement
> with CMS/HCFA for reimbursement of CPT codes.  If the code isn't an
> "official" CPT code, then reimbursement would be denied by CMS,
> even if you weren't sued by the AMA.   If the descriptions didn't
> match the AMA's then they would easily claim it wasn't "official".

It seems I recall several people saying that the CMS/HCFA
*doesn't see* the descriptions? Because they *are not* on
the bill ? But rather the *code only*. Which, by all
accounts anyone could put there by hand off the top of their
head without owning any EMR at all.

Karsten
-- 
GPG key ID E4071346 @ wwwkeys.pgp.net
E167 67FD A291 2BEA 73BD  4537 78B9 A9F9 E407 1346

[openhealth] Re: list of diagnoses and procedures

[mspohr]

Since you only submit the number to CMS and not the description, you
would be submitting an "official" number.  The only issue would be if
you submitted the wrong number based on a description that was not
correct.
For instance, many people publish "instructions" and "clarifications"
for the use of CPT codes since the "official" AMA descriptions can be
ambiguous.  If you relied on a magazine article which had some
incorrect instructions or clarifications on when you could bill using
a certain number, then you could be denied reimbursement... but you
would be denied based on using the wrong billing code.

/Mark


--- In openhealth@yahoogroups.com, David Forslund <[EMAIL PROTECTED]> wrote:
>
> I think the issue is bigger than that.  The AMA has a legal agreement
> with CMS/HCFA for reimbursement of CPT codes.  If the code isn't an
> "official" CPT code, then reimbursement would be denied by CMS,
> even if you weren't sued by the AMA.   If the descriptions didn't
> match the AMA's then they would easily claim it wasn't "official".
> 
> Dave
> mspohr wrote:
> >
> > This decision addresses the question of whether the AMA's copyright
> > becomes invalid when the government mandates it for reimbursement. It
> > uses some tortured logic to say that the CPT is NOT a "system" (that
> > therefore would not be eligible for copyright) but rather an specific
> > expression that can be copyrighted.
> > Following this, it would seem that you could use the "system" (of
> > numbers) but with a different expression (descriptions) and not tread
> > on the AMA's copyright. Other cases (such as with telephone
> > directories) have reaffirmed that you cannot copyright the numbers
> > themselves.
> > However, the AMA would probably sue you anyway.
> >
> > /Mark
> >
> > --- In openhealth@yahoogroups.com 
> > , "Fred Trotter" 
> > wrote:
> > >
> > > I dont think so. From what I understood the codes themselves are
> > copyright.
> > > Further, thier use is mandated by the government for use in medical
> > billing.
> > > This issue has already been the subject of litigation.
> > >
> > > http://www.usdoj.gov/atr/cases/f2000/2076.htm 
> > 
> > >
> > > -FT
> > >
> > > On 12/11/06, mspohr  wrote:
> > > >
> > > > The codes would be the same as those that they currently
accept (i.e.
> > > > the AMA CPT codes) so there is no issue with the codes.
> > > > The problem with the AMA is that they copyright the
descriptions and
> > > > prevent distribution of their copyrighted descriptions.
> > > > The project would be to create new descriptions that were
functionally
> > > > the same and could be freely distributed under an open license
such as
> > > > the Creative Commons license (http://creativecommons.org/ 
> > ).
> > > >
> > > > /Mark
> > > >
> > > >
> > > >
> > > > --- In openhealth@yahoogroups.com 
> > , David Forslund 
wrote:
> > > > >
> > > > > This effort would require commitment from the payor that they
> > > > > would accept those codes for reimbursement. Otherwise this
> > > > > effort will be relatively useless.
> > > > >
> > > > > Dave
> > > > > mspohr wrote:
> > > > > >
> > > > > > The goal of the CPT code project would be to create a
version of
> > > > > > procedure codes for use in billing in the US that could be
freely
> > > > > > distributed.
> > > > > > While it would be nice to fit this into an overarching
> > ontology, this
> > > > > > would introduce overhead which is not warranted. The CPT codes
> > > > > > themselves are a dead end (except for billing in the US)
from both
> > > > > > intellectual property and information design standpoints and
> > the task
> > > > > > of an ontology of procedures is better left to something more
> > suitable
> > > > > > such as Snomed or ICD or even the HCPCS.
> > > > > >
> > > > > > I think KISS applies here.
> > > > > >
> > > > > > /Mark
> > > > > >
> > > > > > --- In openhealth@yahoogroups.com 
> > 
> > > > > > , Adrian Midgley

> > > > > > wrote:
> > > > > > >
> > > > > > > Rod Roark wrote:
> > > > > > > >
> > > > > > > >
> > > > > > > > Perhaps I don't understand what you mean, but CPT
codes are
> > > > just for
> > > > > > > > procedures. The project I was suggesting was limited to
> > > > restating the
> > > > > > > > descriptions for them, with about the same standards for
> > > > preciseness
> > > > > > > > currently found in CPT. A broader scope would be very
> > daunting.
> > > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > > But if we are going to do (an) ontology, let us not handicap
> > > > ourselves
> > > > > > > by building it for just one lot of data. It could be
written one
> > > > > > > chapter at a time, certainly.
> > > > > > >
> > > > > >
> > > > 

[openhealth] Re: list of diagnoses and procedures

[mspohr]

Yes, your paraphrase is correct and it is an absurd situation.  
In the US we have a strong tradition of supporting "free enterprise".
 Unfortunately, this has been corrupted to mean "government granted
monopolies to the private sector".  This is established through our
"free enterprise" election system (contribute to the politician of
your choice who will then pass the legislation you need to run your
business without undue interference from competitors).

This is only a small example of the problem.  A much larger example is
in the case of pharma which patents drug compounds which have been
discovered with government grants.

/Mark


--- In openhealth@yahoogroups.com, "K.S. Bhaskar" <[EMAIL PROTECTED]> wrote:
>
> I find this discussion of CPT codes & reimbursement interesting. 
Let me 
> paraphrase:
> 
> "To petition your Government (for reimbursement), you need to submit 
> your request in Elvish.  Organization XYZ owns the Elvish language. 
> Ergo, to communicate with your Government, you need to buy a license 
> from XYZ to use Elvish."
> 
> This seems quite an incredible state of affairs.
> 
> -- Bhaskar
>

Re: [openhealth] Re: list of diagnoses and procedures

[K.S. Bhaskar]

I find this discussion of CPT codes & reimbursement interesting.  Let me 
paraphrase:

"To petition your Government (for reimbursement), you need to submit 
your request in Elvish.  Organization XYZ owns the Elvish language. 
Ergo, to communicate with your Government, you need to buy a license 
from XYZ to use Elvish."

This seems quite an incredible state of affairs.

-- Bhaskar

Re: [openhealth] Re: list of diagnoses and procedures

[David Forslund]

I think the issue is bigger than that.  The AMA has a legal agreement
with CMS/HCFA for reimbursement of CPT codes.  If the code isn't an
"official" CPT code, then reimbursement would be denied by CMS,
even if you weren't sued by the AMA.   If the descriptions didn't
match the AMA's then they would easily claim it wasn't "official".

Dave
mspohr wrote:
>
> This decision addresses the question of whether the AMA's copyright
> becomes invalid when the government mandates it for reimbursement. It
> uses some tortured logic to say that the CPT is NOT a "system" (that
> therefore would not be eligible for copyright) but rather an specific
> expression that can be copyrighted.
> Following this, it would seem that you could use the "system" (of
> numbers) but with a different expression (descriptions) and not tread
> on the AMA's copyright. Other cases (such as with telephone
> directories) have reaffirmed that you cannot copyright the numbers
> themselves.
> However, the AMA would probably sue you anyway.
>
> /Mark
>
> --- In openhealth@yahoogroups.com 
> , "Fred Trotter" <[EMAIL PROTECTED]>
> wrote:
> >
> > I dont think so. From what I understood the codes themselves are
> copyright.
> > Further, thier use is mandated by the government for use in medical
> billing.
> > This issue has already been the subject of litigation.
> >
> > http://www.usdoj.gov/atr/cases/f2000/2076.htm 
> 
> >
> > -FT
> >
> > On 12/11/06, mspohr <[EMAIL PROTECTED]> wrote:
> > >
> > > The codes would be the same as those that they currently accept (i.e.
> > > the AMA CPT codes) so there is no issue with the codes.
> > > The problem with the AMA is that they copyright the descriptions and
> > > prevent distribution of their copyrighted descriptions.
> > > The project would be to create new descriptions that were functionally
> > > the same and could be freely distributed under an open license such as
> > > the Creative Commons license (http://creativecommons.org/ 
> ).
> > >
> > > /Mark
> > >
> > >
> > >
> > > --- In openhealth@yahoogroups.com 
> , David Forslund  wrote:
> > > >
> > > > This effort would require commitment from the payor that they
> > > > would accept those codes for reimbursement. Otherwise this
> > > > effort will be relatively useless.
> > > >
> > > > Dave
> > > > mspohr wrote:
> > > > >
> > > > > The goal of the CPT code project would be to create a version of
> > > > > procedure codes for use in billing in the US that could be freely
> > > > > distributed.
> > > > > While it would be nice to fit this into an overarching
> ontology, this
> > > > > would introduce overhead which is not warranted. The CPT codes
> > > > > themselves are a dead end (except for billing in the US) from both
> > > > > intellectual property and information design standpoints and
> the task
> > > > > of an ontology of procedures is better left to something more
> suitable
> > > > > such as Snomed or ICD or even the HCPCS.
> > > > >
> > > > > I think KISS applies here.
> > > > >
> > > > > /Mark
> > > > >
> > > > > --- In openhealth@yahoogroups.com 
> 
> > > > > , Adrian Midgley 
> > > > > wrote:
> > > > > >
> > > > > > Rod Roark wrote:
> > > > > > >
> > > > > > >
> > > > > > > Perhaps I don't understand what you mean, but CPT codes are
> > > just for
> > > > > > > procedures. The project I was suggesting was limited to
> > > restating the
> > > > > > > descriptions for them, with about the same standards for
> > > preciseness
> > > > > > > currently found in CPT. A broader scope would be very
> daunting.
> > > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > > But if we are going to do (an) ontology, let us not handicap
> > > ourselves
> > > > > > by building it for just one lot of data. It could be written one
> > > > > > chapter at a time, certainly.
> > > > > >
> > > > >
> > > >
> > >
> > >
> > >
> > >
> > >
> > > Yahoo! Groups Links
> > >
> > >
> > >
> > >
> >
> >
> > --
> > Fred Trotter
> > http://www.fredtrotter.com 
> >
> >
> > [Non-text portions of this message have been removed]
> >
>

[openhealth] Re: list of diagnoses and procedures

[mspohr]

This decision addresses the question of whether the AMA's copyright
becomes invalid when the government mandates it for reimbursement.  It
uses some tortured logic to say that the CPT is NOT a "system" (that
therefore would not be eligible for copyright) but rather an specific
expression that can be copyrighted. 
Following this, it would seem that you could use the "system" (of
numbers) but with a different expression (descriptions) and not tread
on the AMA's copyright.  Other cases (such as with telephone
directories) have reaffirmed that you cannot copyright the numbers
themselves.  
However, the AMA would probably sue you anyway.

/Mark


--- In openhealth@yahoogroups.com, "Fred Trotter" <[EMAIL PROTECTED]>
wrote:
>
> I dont think so. From what I understood the codes themselves are
copyright.
> Further, thier use is mandated by the government for use in medical
billing.
> This issue has already been the subject of litigation.
> 
> http://www.usdoj.gov/atr/cases/f2000/2076.htm
> 
> -FT
> 
> On 12/11/06, mspohr <[EMAIL PROTECTED]> wrote:
> >
> > The codes would be the same as those that they currently accept (i.e.
> > the AMA CPT codes) so there is no issue with the codes.
> > The problem with the AMA is that they copyright the descriptions and
> > prevent distribution of their copyrighted descriptions.
> > The project would be to create new descriptions that were functionally
> > the same and could be freely distributed under an open license such as
> > the Creative Commons license (http://creativecommons.org/).
> >
> > /Mark
> >
> >
> >
> > --- In openhealth@yahoogroups.com, David Forslund  wrote:
> > >
> > > This effort would require commitment from the payor that they
> > > would accept those codes for reimbursement.  Otherwise this
> > > effort will be relatively useless.
> > >
> > > Dave
> > > mspohr wrote:
> > > >
> > > > The goal of the CPT code project would be to create a version of
> > > > procedure codes for use in billing in the US that could be freely
> > > > distributed.
> > > > While it would be nice to fit this into an overarching
ontology, this
> > > > would introduce overhead which is not warranted. The CPT codes
> > > > themselves are a dead end (except for billing in the US) from both
> > > > intellectual property and information design standpoints and
the task
> > > > of an ontology of procedures is better left to something more
suitable
> > > > such as Snomed or ICD or even the HCPCS.
> > > >
> > > > I think KISS applies here.
> > > >
> > > > /Mark
> > > >
> > > > --- In openhealth@yahoogroups.com
> > > > , Adrian Midgley 
> > > > wrote:
> > > > >
> > > > > Rod Roark wrote:
> > > > > >
> > > > > >
> > > > > > Perhaps I don't understand what you mean, but CPT codes are
> > just for
> > > > > > procedures. The project I was suggesting was limited to
> > restating the
> > > > > > descriptions for them, with about the same standards for
> > preciseness
> > > > > > currently found in CPT. A broader scope would be very
daunting.
> > > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > > But if we are going to do (an) ontology, let us not handicap
> > ourselves
> > > > > by building it for just one lot of data. It could be written one
> > > > > chapter at a time, certainly.
> > > > >
> > > >
> > >
> >
> >
> >
> >
> >
> > Yahoo! Groups Links
> >
> >
> >
> >
> 
> 
> -- 
> Fred Trotter
> http://www.fredtrotter.com
> 
> 
> [Non-text portions of this message have been removed]
>

Re: [openhealth] Re: list of diagnoses and procedures

[David Forslund]

I agree. I don't think you would have to declare them something
other than CPT codes even if they had the same number.  With
a different description, they couldn't be certified as the same and
wouldn't come under the legal agreement of CMS (HCFA). 
I think it would be nice to have alternative to CPT, but this would
require more than coming up with code descriptions.  It would require
calling it something else and entering into agreements with CMS and
other organizations including states.  This is not a free exercise.

Dave
Fred Trotter wrote:
>
> I dont think so. From what I understood the codes themselves are 
> copyright.
> Further, thier use is mandated by the government for use in medical 
> billing.
> This issue has already been the subject of litigation.
>
> http://www.usdoj.gov/atr/cases/f2000/2076.htm 
> 
>
> -FT
>
> On 12/11/06, mspohr <[EMAIL PROTECTED] > wrote:
> >
> > The codes would be the same as those that they currently accept (i.e.
> > the AMA CPT codes) so there is no issue with the codes.
> > The problem with the AMA is that they copyright the descriptions and
> > prevent distribution of their copyrighted descriptions.
> > The project would be to create new descriptions that were functionally
> > the same and could be freely distributed under an open license such as
> > the Creative Commons license (http://creativecommons.org/ 
> ).
> >
> > /Mark
> >
> >
> >
> > --- In openhealth@yahoogroups.com 
> , David Forslund <[EMAIL PROTECTED]> 
> wrote:
> > >
> > > This effort would require commitment from the payor that they
> > > would accept those codes for reimbursement. Otherwise this
> > > effort will be relatively useless.
> > >
> > > Dave
> > > mspohr wrote:
> > > >
> > > > The goal of the CPT code project would be to create a version of
> > > > procedure codes for use in billing in the US that could be freely
> > > > distributed.
> > > > While it would be nice to fit this into an overarching ontology, 
> this
> > > > would introduce overhead which is not warranted. The CPT codes
> > > > themselves are a dead end (except for billing in the US) from both
> > > > intellectual property and information design standpoints and the 
> task
> > > > of an ontology of procedures is better left to something more 
> suitable
> > > > such as Snomed or ICD or even the HCPCS.
> > > >
> > > > I think KISS applies here.
> > > >
> > > > /Mark
> > > >
> > > > --- In openhealth@yahoogroups.com 
> 
> > > > , Adrian Midgley 
> > > > wrote:
> > > > >
> > > > > Rod Roark wrote:
> > > > > >
> > > > > >
> > > > > > Perhaps I don't understand what you mean, but CPT codes are
> > just for
> > > > > > procedures. The project I was suggesting was limited to
> > restating the
> > > > > > descriptions for them, with about the same standards for
> > preciseness
> > > > > > currently found in CPT. A broader scope would be very daunting.
> > > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > > But if we are going to do (an) ontology, let us not handicap
> > ourselves
> > > > > by building it for just one lot of data. It could be written one
> > > > > chapter at a time, certainly.
> > > > >
> > > >
> > >
> >
> >
> >
> >
> >
> > Yahoo! Groups Links
> >
> >
> >
> >
>
> -- 
> Fred Trotter
> http://www.fredtrotter.com 
>
> [Non-text portions of this message have been removed]
>
> _

Re: [openhealth] Re: list of diagnoses and procedures

[Fred Trotter]

I dont think so. From what I understood the codes themselves are copyright.
Further, thier use is mandated by the government for use in medical billing.
This issue has already been the subject of litigation.

http://www.usdoj.gov/atr/cases/f2000/2076.htm

-FT

On 12/11/06, mspohr <[EMAIL PROTECTED]> wrote:
>
> The codes would be the same as those that they currently accept (i.e.
> the AMA CPT codes) so there is no issue with the codes.
> The problem with the AMA is that they copyright the descriptions and
> prevent distribution of their copyrighted descriptions.
> The project would be to create new descriptions that were functionally
> the same and could be freely distributed under an open license such as
> the Creative Commons license (http://creativecommons.org/).
>
> /Mark
>
>
>
> --- In openhealth@yahoogroups.com, David Forslund <[EMAIL PROTECTED]> wrote:
> >
> > This effort would require commitment from the payor that they
> > would accept those codes for reimbursement.  Otherwise this
> > effort will be relatively useless.
> >
> > Dave
> > mspohr wrote:
> > >
> > > The goal of the CPT code project would be to create a version of
> > > procedure codes for use in billing in the US that could be freely
> > > distributed.
> > > While it would be nice to fit this into an overarching ontology, this
> > > would introduce overhead which is not warranted. The CPT codes
> > > themselves are a dead end (except for billing in the US) from both
> > > intellectual property and information design standpoints and the task
> > > of an ontology of procedures is better left to something more suitable
> > > such as Snomed or ICD or even the HCPCS.
> > >
> > > I think KISS applies here.
> > >
> > > /Mark
> > >
> > > --- In openhealth@yahoogroups.com
> > > , Adrian Midgley 
> > > wrote:
> > > >
> > > > Rod Roark wrote:
> > > > >
> > > > >
> > > > > Perhaps I don't understand what you mean, but CPT codes are
> just for
> > > > > procedures. The project I was suggesting was limited to
> restating the
> > > > > descriptions for them, with about the same standards for
> preciseness
> > > > > currently found in CPT. A broader scope would be very daunting.
> > > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > But if we are going to do (an) ontology, let us not handicap
> ourselves
> > > > by building it for just one lot of data. It could be written one
> > > > chapter at a time, certainly.
> > > >
> > >
> >
>
>
>
>
>
> Yahoo! Groups Links
>
>
>
>


-- 
Fred Trotter
http://www.fredtrotter.com


[Non-text portions of this message have been removed]

Re: [openhealth] Re: list of diagnoses and procedures

[David Forslund]

So could one use the CPT number for reimbursement without some
certification that they are the same as the "real" CPT codes?

Dave
mspohr wrote:
>
> The codes would be the same as those that they currently accept (i.e.
> the AMA CPT codes) so there is no issue with the codes.
> The problem with the AMA is that they copyright the descriptions and
> prevent distribution of their copyrighted descriptions.
> The project would be to create new descriptions that were functionally
> the same and could be freely distributed under an open license such as
> the Creative Commons license (http://creativecommons.org/ 
> ).
>
> /Mark
>
> --- In openhealth@yahoogroups.com 
> , David Forslund <[EMAIL PROTECTED]> 
> wrote:
> >
> > This effort would require commitment from the payor that they
> > would accept those codes for reimbursement. Otherwise this
> > effort will be relatively useless.
> >
> > Dave
> > mspohr wrote:
> > >
> > > The goal of the CPT code project would be to create a version of
> > > procedure codes for use in billing in the US that could be freely
> > > distributed.
> > > While it would be nice to fit this into an overarching ontology, this
> > > would introduce overhead which is not warranted. The CPT codes
> > > themselves are a dead end (except for billing in the US) from both
> > > intellectual property and information design standpoints and the task
> > > of an ontology of procedures is better left to something more suitable
> > > such as Snomed or ICD or even the HCPCS.
> > >
> > > I think KISS applies here.
> > >
> > > /Mark
> > >
> > > --- In openhealth@yahoogroups.com 
> 
> > > , Adrian Midgley 
> > > wrote:
> > > >
> > > > Rod Roark wrote:
> > > > >
> > > > >
> > > > > Perhaps I don't understand what you mean, but CPT codes are
> just for
> > > > > procedures. The project I was suggesting was limited to
> restating the
> > > > > descriptions for them, with about the same standards for
> preciseness
> > > > > currently found in CPT. A broader scope would be very daunting.
> > > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > But if we are going to do (an) ontology, let us not handicap
> ourselves
> > > > by building it for just one lot of data. It could be written one
> > > > chapter at a time, certainly.
> > > >
> > >
> >
>
> _

[openhealth] Re: list of diagnoses and procedures

[mspohr]

The codes would be the same as those that they currently accept (i.e.
the AMA CPT codes) so there is no issue with the codes.
The problem with the AMA is that they copyright the descriptions and
prevent distribution of their copyrighted descriptions.  
The project would be to create new descriptions that were functionally
the same and could be freely distributed under an open license such as
the Creative Commons license (http://creativecommons.org/).

/Mark



--- In openhealth@yahoogroups.com, David Forslund <[EMAIL PROTECTED]> wrote:
>
> This effort would require commitment from the payor that they
> would accept those codes for reimbursement.  Otherwise this
> effort will be relatively useless.
> 
> Dave
> mspohr wrote:
> >
> > The goal of the CPT code project would be to create a version of
> > procedure codes for use in billing in the US that could be freely
> > distributed.
> > While it would be nice to fit this into an overarching ontology, this
> > would introduce overhead which is not warranted. The CPT codes
> > themselves are a dead end (except for billing in the US) from both
> > intellectual property and information design standpoints and the task
> > of an ontology of procedures is better left to something more suitable
> > such as Snomed or ICD or even the HCPCS.
> >
> > I think KISS applies here.
> >
> > /Mark
> >
> > --- In openhealth@yahoogroups.com 
> > , Adrian Midgley  
> > wrote:
> > >
> > > Rod Roark wrote:
> > > >
> > > >
> > > > Perhaps I don't understand what you mean, but CPT codes are
just for
> > > > procedures. The project I was suggesting was limited to
restating the
> > > > descriptions for them, with about the same standards for
preciseness
> > > > currently found in CPT. A broader scope would be very daunting.
> > > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > But if we are going to do (an) ontology, let us not handicap
ourselves
> > > by building it for just one lot of data. It could be written one
> > > chapter at a time, certainly.
> > >
> >
>

Re: [openhealth] Re: list of diagnoses and procedures

[David Forslund]

This effort would require commitment from the payor that they
would accept those codes for reimbursement.  Otherwise this
effort will be relatively useless.

Dave
mspohr wrote:
>
> The goal of the CPT code project would be to create a version of
> procedure codes for use in billing in the US that could be freely
> distributed.
> While it would be nice to fit this into an overarching ontology, this
> would introduce overhead which is not warranted. The CPT codes
> themselves are a dead end (except for billing in the US) from both
> intellectual property and information design standpoints and the task
> of an ontology of procedures is better left to something more suitable
> such as Snomed or ICD or even the HCPCS.
>
> I think KISS applies here.
>
> /Mark
>
> --- In openhealth@yahoogroups.com 
> , Adrian Midgley <[EMAIL PROTECTED]> 
> wrote:
> >
> > Rod Roark wrote:
> > >
> > >
> > > Perhaps I don't understand what you mean, but CPT codes are just for
> > > procedures. The project I was suggesting was limited to restating the
> > > descriptions for them, with about the same standards for preciseness
> > > currently found in CPT. A broader scope would be very daunting.
> > >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > But if we are going to do (an) ontology, let us not handicap ourselves
> > by building it for just one lot of data. It could be written one
> > chapter at a time, certainly.
> >
>

[openhealth] Re: list of diagnoses and procedures

[mspohr]

The goal of the CPT code project would be to create a version of
procedure codes for use in billing in the US that could be freely
distributed.
While it would be nice to fit this into an overarching ontology, this
would introduce overhead which is not warranted.  The CPT codes
themselves are a dead end (except for billing in the US) from both
intellectual property and information design standpoints and the task
of an ontology of procedures is better left to something more suitable
such as Snomed or ICD or even the HCPCS.

I think KISS applies here.

/Mark


--- In openhealth@yahoogroups.com, Adrian Midgley <[EMAIL PROTECTED]> wrote:
>
> Rod Roark wrote:
> >
> >
> > Perhaps I don't understand what you mean, but CPT codes are just for
> > procedures. The project I was suggesting was limited to restating the
> > descriptions for them, with about the same standards for preciseness
> > currently found in CPT. A broader scope would be very daunting.
> >
> 
> 
> 
> 
> 
> 
> 
> 
> 
> But if we are going to do (an) ontology, let us not handicap ourselves
> by building it for just one lot of data.  It could be written one
> chapter at a time, certainly.
>