AANS Tackles Imaging Preauthorization and ICD-10 Implementation
The AANS is among 19 signatories of a letter to Congress that expresses concern with the findings of the report, Medicare Part B Imaging Services: Rapid Spending Growth and Shift to Physician Offices Indicate Need for CMS to Consider Additional Management Practices, which was recently released by the Government Accountability Office. The first of two installments, this report advised the Centers for Medicare and Medicaid Services to consider implementing prior authorization, using radiology benefit management companies, RBMs, for imaging services provided to Medicare beneficiaries. According to the letter, which was addressed to the two senators who requested the report, John D. Rockefeller IV, chair of the Senate Committee on Finance—Subcommittee on Health, and Gordon H. Smith, ranking member of the Senate Special Committee on Aging: “Physician members have found that prior authorization through RBMs is an intrusion in the physician-patient relationship and amounts to a large administrative burden for physician practices, particularly small practices, and negatively impacts the quality of patient care.” The letter further states that “prior authorization is not effective at enhancing the quality of imaging tests” and concludes, “we do not believe prior authorization is the solution and have significant concern about its negative impact on quality patient care.” https://www.gao.gov/new.items/d08452.pdf
ICD-10 Implementation
The AANS is part of a coalition that has been seeking
to delay implementation of the new ICD-10
diagnoses and hospital procedure code system until
after 2012. On Aug. 15 the Centers for Medicare
and Medicaid Services published a proposed rule,
effective Oct. 1, 2011, changing the current ICD-9
coding system to the new ICD-10 system. The ICD-10 is mandated by the Health Insurance Portability
and Accountability Act. Doctors will need to use new
ICD-10 diagnosis codes, which now number about
155,000 rather than the current 17,000 under the
current system. In addition, a separate rule also was
released that requires adoption of a new electronic
transaction standard, version 5010, by April 2010,
which is essential for using ICD-10. The CMS
accepted comments on the ICD-10 code sets and on
the transaction standards proposed rules until Oct.
21. www.hhs.gov/news/press/2008pres/08/2008
0815a.html