March 15, 2011
Disability Duration Guidelines by CPT © Procedure Code
CA – Work Loss Data Institute (WLDI) announces a new feature to its
Return-to-Work Best Practice Guidelines - Forecasting disability duration
by CPT © code. This feature is
available in the online versions of the Official
Disability Guidelines (ODG) Product Line.
Procedural Terminology (CPT ©)
codes, as developed by and licensed from the American Medical Association,
have long been included in ODG for use in treatment and reimbursement
decisions, but disability duration guidelines by CPT code required use of
an ODG mapping to the corresponding ICD9 diagnosis code, where procedures
are addressed by name. With the new CPT framework, users can access the
ODG Best Practice Guidelines at the CPT level for more than 3,600 surgical
or otherwise invasive procedures covered by Current Procedural Terminology
in the ODG CPT Index.
new CPT Best Practice Guidelines are based on the ODG database of over 10
million cases from three major data
sources, including actual workers’ comp and STD/LTD insurance claims
data, the National Center for Health Statistics’ National Health
Interview Survey, and the Survey of Occupational Injuries and Illnesses by
the Bureau of Labor Statistics. The use of these three unique data
sources ensures that ODG has sufficient data that is both occupational and
non-occupational; insurance claims and non-benefit related; plus
self-reported, employer-reported, and physician-coded. In all, ODG
comprises the largest database of absence management data in the world.
from the three sources are cleansed, purged of deficiencies, and
normalized using a sophisticated three-dimensional relational database
system, and then bucketed into RTW pathways differentiated by severity
indicators, type of treatment, and type of job. Disability duration
targets for each pathway are developed using a proprietary Expected Value
System, which uses a weighted average skewed towards the median, and
considers also the mode, mean and standard deviation.
The draft version of the Best Practice Guidelines is then
distributed to members of the ODG Editorial Advisory Board for their
annual peer review and consensus process. The Board consists of
approximately 100 doctors and leading health professionals, who review the
guidelines and make any adjustments deemed necessary to reflect current
industry best practices, before publication in ODG.
of ODG can access the new CPT © Best
Practice Guidelines in the CPT Index of the Web version of ODG, accessible
under Section B of the Contents Page. For new orders, the annual
subscription cost is $85 to $325 annually, based on quantity.
WLDI is an
independent database development company focused on workplace health and
productivity based in Encinitas, California. Currently in its 16th
annual edition and available in Web-based, textbook and Systems
Integration formats, ODG 2011 provides evidence-based medical treatment,
UR and disability duration guidelines to improve as well as benchmark
outcomes in workers’ comp and non-occupational disability.
For more information, visit www.worklossdata.com
or contact WLDI at 800-488-5548.
CPT © 2010 American Medical Association. All Rights Reserved.
No fee schedules, basic units, relative values or related listings are
included in CPT. AMA does not directly or indirectly practice
medicine or dispense medical services. AMA assumes no liability for data
contained or not contained herein.
CPT is a registered trademark of the American Medical Association