Risk, Stress Should Be Used to Determine Relative Values for Acupuncture Points
Shane Burras' article "AIMS Conducts Analysis of New CPT Codes" is for the most part dead-on, but omitted a very important point.
The risk to the patient and the stress on the provider, two very key points in determining a code's relative value, vary by acupuncture point. As a rule, points on the limbs and buttocks cannot with respect to the above two relative value factors be grouped with the same relative value of points overlying vital organs and structures, which, if punctured incorrectly, can cause serious medical injury (if not death).
Where is the fairness when the AMA CPT Committee assigns over 50 relative values for X-rays depending on the particulars of what is being X-rayed, and then apparently "assumes" that there are no such differences when points are needled that overlie the heart, lungs, kidneys, liver, brain stem, eyes, carotid artery, etc.? While I have never heard of an experienced acupuncturist puncturing any vital organ, one would be hard-pressed to find any responsible acupuncturist who stated that he or she did not take extraordinary care and caution needling such points, and that failure to do so would not pose a greater risk of harm to the patient.
The outcome of any efforts to correct the problems with the new acupuncture CPT codes would be no less egregious if, at minimum, different relative values were not assigned by grouping points based on the risk to the patient and the stress put on the physician.
Jeff Reininger, LAc, DOM, AP Ft. Lauderlade, Florida
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