Magazine article Drug Topics

MTM Codes May Become Permanent, R.Ph.S Hope

Magazine article Drug Topics

MTM Codes May Become Permanent, R.Ph.S Hope

Article excerpt

Pharmacy representatives attending an American Medical Association's Current Procedural Terminology (CPT) editorial panel meeting recently in San Diego have asked the panel to make codes for medication therapy management (MTM) permanent.

MTM refers to in-person services for patients beyond routine dispensing of prescription medication and related information leaflets. The codes are used to bill any health plan that covers MTM services, including the Medicare Part D prescription drug benefit.

The MTM CPT codes were created in 2005 and became effective in January 2006 in category III. Category III codes are temporary codes created for emerging technology either to collect data for FDA approval or to confirm widespread usage. Over the past two years, there have been nearly 900,000 documented cases of MTM services at 240 pharmacy sites across the United States, reported Daniel Buffington, Pharm.D., MBA. Buffington sits on the CPT editorial panel as a representative of the Pharmacist Services Technical Advisory Coalition (PSTAC). He is also president and CEO of Clinical Pharmacology Services. He presented the findings of a recent survey of pharmacists and third-party payers regarding MTM services.

The three temporary MTM codes-0115T, 0116T, and +0117T-represent the pharmacist's initial encounter with the patient, follow-up assessment, and each additional 15 minutes with the patient, respectively.

PSTAC used the example of a 66-year-old female with osteoporosis, Type 2 diabetes, and hyperlipidemia.

Assessment of a patient with multiple diseases and Rxs may include taking a full medical and medication history; determining the appropriateness of the prescribed therapy; assessing lab data; assessing the potential for negative interactions involving multiple Rx drugs, drugs and the disease, and drugs and other nutrients; and developing a plan to optimize therapy.

The pharmacist reviews all medications, including Rxs, over-the-counter drugs, and herbal supplements being used by the patient for negative interactions, duplications, and under- or overdosing.

The editorial panel's Feb. 8 vote on the proposal is confidential until AMA publishes its CPT Manual 2008, expected in August. If the proposal is approved by the panel, the codes will be effective in January 2008 as category I codes, according to Kathryn Kuhn, R. …

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