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February 14, 2012 — In acknowledgment to complaints from organized medicine, the Centers for Medicare and Medicaid Casework (CMS) will accede blame aback the borderline for physicians and added providers to alpha application a abundant set of analytic codes frequently accepted as ICD-10.
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The borderline for converting from the accepted ICD-9 analysis codes to the new set is October 1, 2013, but the American Medical Association (AMA) told the Department of Bloom and Human Casework in a letter aftermost ages that the aerial amount of authoritative the about-face would disproportionately accountability physicians. The AMA puts that amount at anywhere from $83,000 to added than $2.7 million, depending on the admeasurement of the practice.
The claiming of adopting the new analytic codes additionally promises to baffle with the adeptness of physicians to apparatus cyberbanking bloom annal (EHRs), according to the AMA. Failing to digitize their practices could betrayal them to penalties beneath Medicare's e-prescribing and EHR "meaningful use" programs.
Marilyn Tavenner
CMS Acting Administrator Marilyn Tavenner told reporters at the AMA's National Advocacy Conference in Washington, DC, today that her bureau would "re-examine the timeframe" for ICD-10.
"There's affair that association cannot get their assignment done about allusive use, their assignment about ICD-10 implementation, and be accessible for (insurance) exchanges," Tavenner was quoted as adage in appear reports. "So we're aggravating to accept to that and be responsive." A CMS agent said the appear quotes are accurate.
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ICD-10 stands for the International Statistical Classification of Diseases, 10th Revision, developed by the Apple Bloom Organization. As with ICD-9, ICD-10 consists of "CM" codes for diagnoses and "PCS" codes for procedures. Physicians charge accept the ICD-10 analysis codes, but not its action codes. Instead, they will abide to use Accepted Action Terminology (CPT) codes and those in the Healthcare Common Action Coding System (HCPCS) to certificate their casework in appointment and outpatient settings.
CMS allowable the about-face to ICD-10 in 2009 as allotment of implementing theHealth Allowance Portability and Accountability Act (HIPAA). The bureau admired ICD-9 as outdated, abounding with anachronistic terms, and bound in its adeptness to abduction abstracts and alarm abreast medical practice.
It additionally said that that the anatomy of ICD-9 banned the banknote of new codes.
ICD-10 encompasses 68,000 analytic codes, or 5 times as abounding as ICD-9. In addition, ICD-10 codes extend to as abounding as 7 characters, while their ICD-9 counterparts accommodate 5 at most.
It is the arduous complication of the new cipher set that has prompted the AMA to ask HHS to acquisition addition backup for ICD-9. Physicians accept ridiculed the assiduous attention of new codes such as W6161XA, which applies to a avoid chaw apparent during an antecedent accommodating encounter, as against to W6162XA, which refers to actuality addled by a duck. There are codes for injuries acquired by walking into lampposts and accepting ashamed amid a baiter and addition affectionate of watercraft.
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However, if CMS sticks to its borderline for ICD-10 compliance, and physicians abide to use the old codes on their allowance claims, the after-effects are no bedlam matter. The claims will not be paid.
ICD-10 Has Supporters in Healthcare Industry
Not anybody in the healthcare industry agrees that ICD-10 should be scrapped, or that its borderline should be delayed. The American Bloom Information Management Association (AHIMA) has apprenticed the government to stick to its ICD-10 timetable. Sue Bowman, AHIMA's administrator of coding action and compliance, told Medscape Medical News that the success of healthcare ameliorate hinges on the new cipher set.
"Payment reform, answerable affliction organizations — they all depend on added abundant data," said Bowman. "ICD-9 is added than 30 years old. The anatomy is no best able to abutment the specificity accepted by healthcare."
She said that "hype" about the cardinal of codes in ICD-10 has afraid the medical world.
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"There are added codes, but it's not like you go through the absolute account to accept one," Bowman said. "It's like a dictionary. It doesn't accomplish it harder to use back you add added words." She additionally acclaimed that physicians about amusement alone a bound cardinal of diagnoses.
The AMA's contempo alarm to acquisition addition backup for ICD-9 strikes Bowman as advancing backward in the authoritative game. "The final aphorism for ICD-10 came out in January 2009," she said. In contrast, added players in the healthcare industry, such as hospitals and medical software companies, are accomplishment advanced to absorb the new analytic codes into their systems, according to Bowman.
Physicians Additionally Want New Cyberbanking Claims Standard Delayed
Physicians accept asked CMS to apathetic things bottomward on addition HIPAA claim that is accompanying to ICD-10 — the so-calledVersion 5010 standards administering cyberbanking allowance claims and accompanying affairs such as requests for accommodation status. The Version 5010 standards were set to booty aftereffect January 1, but CMS delayed the administration date until March 31 to accord providers added time to retool their software.
However, the Medical Group Management Association (MGMA) asked HHS beforehand this ages to added adjournment the administration date until at atomic June 30. The MGMA said that abounding of its affiliate practices had attempted to about-face over to the new cyberbanking claims standards alone to acquisition their Medicare claims activity unpaid. Some practices accept not accustomed a Medicare acquittal back aftermost November, according to the MGMA.
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Only the Version 5010 standards absorb the use of ICD-10. Billing software based on the earlier Version 4010 standards is adverse with the new codes.
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