[openhealth] Re: list of diagnoses and procedures

--- In openhealth@yahoogroups.com, "Fred Trotter" <[EMAIL PROTECTED]> wrote: > > > A "derivative work" includes some portion > > of the original verbatim and that should be avoided. > > > > > In order to work for billing the codes themselves would have to be carried > over from the CPT system. Th

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

> A "derivative work" includes some portion > of the original verbatim and that should be avoided. > > In order to work for billing the codes themselves would have to be carried over from the CPT system. Thus making any attempt to "re-describe" CPT codes a derivative work and largely useless. -F

[openhealth] Re: list of diagnoses and procedures

The copyright covers "expressions of ideas", not the ideas themselves. You can certainly reference the original "idea" (description) and create a new "expression". A "derivative work" includes some portion of the original verbatim and that should be avoided. The idea of the patient not being abl

[openhealth] Re: list of diagnoses and procedures

Reply to the length of copyright proposed by John Bergman Re: list of diagnoses and procedures

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

On Tue, Dec 12, 2006 at 10:24:52AM +, 80n wrote: > Is it doable to create new descriptions from just the codes. Unless the > meaning of each code is common knowledge then you have to make recourse to > the original description, which makes your description a derived work at the > very least.

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

All, It is interesting how much energy this conversation is getting. Now, I must admit that I am not pleased with any government granted monopoly. There are certain rights (and I am not a lawyer) granted under the referenced FARS/DFARS for end-users. You need to check those for yourself or c

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

Is it doable to create new descriptions from just the codes. Unless the meaning of each code is common knowledge then you have to make recourse to the original description, which makes your description a derived work at the very least. Is there any clean-room way of arriving at a description that

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

On Mon, Dec 11, 2006 at 10:54:32PM -0800, Rod Roark wrote: > 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, You guys need to keep straight what you are talking about. At

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

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 descri

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

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 tak

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

: 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

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

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

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

[openhealth] Re: list of diagnoses and procedures

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

[openhealth] Re: list of diagnoses and procedures

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 s

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

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 fro

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

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

[openhealth] Re: list of diagnoses and procedures

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 b

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

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 CP

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

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]

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

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

[openhealth] Re: list of diagnoses and procedures

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 description

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

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 c

[openhealth] Re: list of diagnoses and procedures

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

[openhealth] Re: list of diagnoses and procedures

I can confirm this from doing my own billing in my practice. Only the code numbers are used. The descriptions are not included, neither on the printed CMS 1500 claim forms, nor the electronic ANSI X12 837 format. Alex Caldwell --- In openhealth@yahoogroups.com, Rod Roark <[EMAIL PROTECTED]> wrote

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

Payers will always invent excuses to reject claims. However in my experience the CPT description is not submitted as part of a claim. Rod www.sunsetsystems.com On Saturday 09 December 2006 14:53, Peter Holt Hoffman wrote: > I have a question about this though: don't at least some payers > rejec

[openhealth] Re: list of diagnoses and procedures

I have a question about this though: don't at least some payers reject claims where the description is not 100% identical to what the AMA publishes? -- Peter. --- In openhealth@yahoogroups.com, Rod Roark <[EMAIL PROTECTED]> wrote: > > I think, then, a good web-based community project w

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

I think, then, a good web-based community project would be the creation of a whole new set of codes and descriptions. However the codes would happen to map one-to-one with the CPT codes, and the mapping would be created/shared only among those with CPT licenses. Publications that reference CPT co

[openhealth] Re: list of diagnoses and procedures

Copyright covers "expressions" of ideas and as such covers the AMA's descriptions. Theoretically, if you wrote different descriptions, they would not be covered by the AMA copyright. However, the AMA has been very aggressive in defending their monopoly on the codes so they might threaten a commun

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

That leads me to ask: does the AMA claim copyright on the CPT codes themselves, or just on the descriptions of the codes? If the latter, I think there would be a lot of merit in a community project to create and maintain new descriptions. I've been told that the AMA's descriptions are not very ph

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

This reminds me of a similar situation in the UK with postcodes (their equivalent of zip codes). Unlike the US where zip codes are in the public domain, the British Post Office owns the postcode database and protects it agressively. An enterprising group of people recently started an initiative a

[openhealth] Re: list of diagnoses and procedures

The AMA CPT codes have a tortuous history and are currently in a legally ambiguous place supported by aggressive AMA lawyers. It is similar to the legally tenuous position of the RIAA that they can control what you can do with the music you have purchased. A short history. In testimony before co

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

Tim Cook wrote: > > I should have provided a reference for my quote. It is from the > "clickable" license agreement on the AMA site. > I should have probably also noted that they are available from the AMA on CD in ASCII for less than $100 / year. So it would be cheaper to purchase them than

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

Alex Caldwell wrote: > Thanks Tim, > > I was going by the agreement on this page on the CMS site which links > to the download for the Excel file: > > http://www.cms.hhs.gov/apps/ama/license.asp?file=http://new.cms.hhs.gov/apps/ama/report_xyz.pdf > > It did not seem to me as restrictive as what

[openhealth] Re: list of diagnoses and procedures

--- In openhealth@yahoogroups.com, Tim Cook <[EMAIL PROTECTED]> wrote: > > Alex Caldwell wrote: > The way I interpret the agreement on > > the site, I believe it is OK to do this as long as you just do it > > just for yourself for your own internal use, but you are not allowed > > to re-distribut

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

Alex Caldwell wrote: The way I interpret the agreement on > the site, I believe it is OK to do this as long as you just do it > just for yourself for your own internal use, but you are not allowed > to re-distribute them. So perhaps it would be OK to distribute the > Open Source EMR minus these c

[openhealth] Re: list of diagnoses and procedures

--- In openhealth@yahoogroups.com, Adrian Midgley <[EMAIL PROTECTED]> wrote: > > "a list of diagnoses and procedures > > Does anyone know one which is free to use and edit if needed and in an > easy format to parse into a database" > > Asked a colleague in another place. Do we have a list of