The Centers for Medicare & Medicaid Services, in an Aug. 22 proposed rule, called for physicians, hospitals and health plans to make the transition to the 10th revision of the International Classification of Diseases code sets standard. ICD-10 has roughly 65,000 diagnostic codes, about five times as many as ICD-9. Physicians use ICD codes to record patient diagnoses and Current Procedural Terminology codes to record the procedures they provide to patients. Hospitals use ICD for both coding processes.
Before physicians, hospitals and others can use the new code sets, they must upgrade their electronic transaction systems to be compatible. CMS, in a separate proposed rule, set an adoption deadline of April 1, 2010, for these transaction standards.
Joseph M. Heyman, MD, chair of the AMA Board of Trustees, said putting into practice both the new coding system and the transaction standards by 2011 is asking too much from physicians. "CMS is setting the stage for major implementation problems."
William F. Jessee, MD, president and CEO of the Medical Group Management Assn., said CMS should not underestimate the difficulty of such a systemwide change. "Moving to these new code sets has the potential to be the most complex change for the U.S. health care system in decades."
ICD-10 has about 65,000 diagnostic codes, 5 times as many as ICD-9.
Small practices challenged
In the proposed rule, CMS estimates that implementing ICD-10 will cost all physician practices in the U.S. only about $138 million, or 0.4% of total practice revenues.
CMS expects payers and specialty societies will provide updated "superbills,"
"We recognize that the transition to ICD-10 will require some up-front costs," said Acting CMS Administrator Kerry Weems. But every day that passes without the codes being used is a lost opportunity to measure more precisely the value of health care spending, he said.
While the full extent of the impact of ICD-10 and the new electronic transaction standards is difficult to predict, "it's certainly going to be a burden on the physicians,"
Outsourcing your medical billing may be the answer, but make sure you go with a company that is compliant with the new ICD-10 codes.
Ken Martinez, president of Payment Automation Network said, "our system is already ICD-10 compliant. Our physicians will not have any disruption in their billing".
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