At its September 2021 meeting, the CPT® Editorial Panel accepted the addition of a new Appendix S to guide classifying various artificial intelligence/augmented intelligence (AI) applications. This taxonomy guides classifying various artificial intelligence/augmented intelligence (AI) applications (e.g., expert systems, machine learning, algorithm-based services) for medical services and procedures into one of three categories: assistive, augmentative, or autonomous.
AI as applied to health care may differ from AI in other public and private sectors (e.g., banking, energy, transportation). Note that there is no single product, procedure or service for which the term “AI” is sufficient or necessary to describe its intended clinical use or utility; therefore, the term “AI” is not defined in the code set.
In addition, the term “AI” is not intended to encompass or constrain the full scope of innovations that are characterized as “work done by machines.” Classification of AI medical services and procedures as assistive, augmentative, or autonomous is based on the clinical procedure or service provided to the patient and the work performed by the machine on behalf of the physician or other qualified health care professional (QHP).
Assistive classification: The work performed by the machine for the physician or other QHP is assistive when the machine detects clinically relevant data without analysis or generated conclusions. Requires physician or other QHP interpretation and report.
Augmentative classification: The work performed by the machine for the physician or other QHP is augmentative when the machine analyzes and/or quantifies data to yield clinically meaningful output. Requires physician or other QHP interpretation and report.
Autonomous: The work performed by the machine for the physician or other QHP is autonomous when the machine automatically interprets data and independently generates clinically meaningful conclusions without a concurrent physician or other QHP involvement. Autonomous medical services and procedures include interrogating and analyzing data. The work of the algorithm may or may not include the acquisition, preparation, and/or transmission of data.
There are three levels of autonomous AI medical services and procedures with varying physician or other QHP professional involvement: Level I—The autonomous AI draws conclusions and offers diagnosis and/or management options, which are contestable and require a physician or other QHP action to implement; Level II— The autonomous AI concludes and initiates diagnosis and/or management options with an alert/opportunity for override, which may require a physician or other QHP action to implement; and Level III— The autonomous AI concludes and initiates management, which requires physician or other QHP initiative to contest.
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