Sunday, July 12, 2015

Docs, feds compromise on switch

The American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) announced a compromise on the switch to ICD-10-CM.  The AMA, for its part, will begin investing time and effort into helping physicians get ready for the switch.  CMS, in response, will approve claims encoded with ICD-10-CM even if the specific ICD-10-CM code used wouldn't normally meet "specificity" criteria for payment.  That means a doctor would receive payment for coding an injury with a code that does not indicate the laterality of the injury, for example.

Each side, however, remains firm on its stance on whether the switch should happen at all.  The AMA and many of its state-level affiliates (especially California, New York, Texas, and Pennsylvania) remain staunchly opposed to the switch.  CMS remains insistent that the switch should and will occur.  Of course, Congress overrode that insistence last year, postponing the switch by an additional year.  This year, legislative relief from the switch seems unlikely, although we should all continue to press for it.  Stop the switch!

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