Medicare reimbursement codes: Hopes are high for keeping CPT

An advisory committee appears ready to recommend changing to the ICD-10 coding system for inpatient settings only.

By Markian Hawryluk, AMNews staff. Oct. 20, 2003.

Washington -- Physicians generally don't like to be overlooked. But when it comes to replacing their Medicare coding system, physicians won't complain if they get passed by.

Fortunately, the chances that physicians will have to abandon the 8,000-code Current Procedural Terminology system used by most public and private health care payers for a new 170,000-code system are becoming increasingly remote as a federal advisory committee prepares to make its recommendations on the issue.

At the September meeting of the National Committee on Vital and Health Statistics, discussions on moving to the new coding system -- the International Classification of Diseases, 10th revision -- focused exclusively on inpatient hospital settings. This left physician groups cautiously optimistic that they have avoided a costly and complicated mandate.

"The physician community is united in its concern that application of the ICD code set in all settings, and not just as currently used, would create chaos and a dramatic increase in administrative hassles associated with coding for physicians," said Edward L. Langston, MD, an American Medical Association trustee.

While the NCVHS has yet to finalize its recommendations to the Dept. of Health and Human Services, physician groups and coding experts say it is unlikely the panel will support replacing the codes now used by physicians.

"I don't think there's any intention or desire to replace CPT at all," said Sue Prophet-Bowman, director of coding policy and compliance for the American Health Information Management Assn.