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Doctors Ask Regulators to Push Billing Code Shift Back Another Year

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The American Medical Association (AMA) says federal regulators should give physicians at least 2 extra years to adopt a new diagnostic code system, not just 1 extra year.

The U.S. Department of Health and Human Services (HHS) announced last week that it will push the diagnostic code shift implementation date back to Oct. 1, 2014, from Oct. 1, 2013.

The diagnostic code shift postponement final rule is set to appear in the Federal Register Sept. 5.

The AMA, Chicago, says members welcome the 1-year reprieve but need more help.

The diagnostic code shift will be coming “at a time when physicians are dealing with the implementation of multiple Medicare incentive and penalty programs,” the AMA says in a statement. “Physicians are also already trying to engage in new delivery and payment models.”

Shifting to a new diagnostic code at the same time will add to the pressure on doctors and reduce their ability to focus on patients, the AMA says.

The shift involves a switch to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), from the current diagnostic code standard, ICD-9.  The ICD-9 standard is based on work done in the 1970s and provides about 13,000 codes. The ICD-10 standard was developed in the 1990s and has 68,000 codes.

Health insurers are hoping the shift will help make billing more precise and give researchers, care managers and others information they can use to detect trends in care and improve the quality of care.

The AMA says quintupling the number of diagnostic codes physician offices must learn and use will be a significant burden on physicians. The AMA’s governing body, the House of Delegates, recently voted to study the idea of shifting directly to the version of the ICD now in development, ICD-11, and skipping ICD-10 altogether.


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