CMS officials said the federal agency will speed up and make more transparent the approval process for new billing codes for the Medicare and Medicaid programs, making it possible for providers to obtain reimbursements more quickly for new technologies and procedures.
"By working with patient advocates, healthcare payers and the suppliers and manufacturers of medical products, we have been able to identify many opportunities for improvements in the current coding process to keep coding issues from slowing the dissemination of new and improved treatments," said CMS Administrator Mark McClellan, M.D., in a statement announcing the changes Wednesday.
Use of the Healthcare Common Procedure Coding System, which was established in 1978 for voluntary use, was made mandatory by implementation of the Health Insurance Portability and Accountability Act of 1996.
Changes in the code approval process will be phased in over the next 18 months, according to the government. They include:
Ten years ago, the CMS reported handling about 50 coding requests a year, but the number has increased to 300 a year.
Rita Scichilone, director of coding services for the American Health Information Management Association, Chicago, welcomed the changes.
"Any improvement that speeds the use of technology and reporting out the codes quicker is a good thing," Scichilone said. "It's always good to open the process up a little bit."
Scichilone said the move by the CMS follows the addition in 2000 by the American Medical Association, the keeper of the Current Procedural Terminology, or CPT code system, of a temporary CPT Category III code set for emerging technology.
For example, online patient visits, until a permanent code can be reviewed and approved, were a recent use of the CPT Category III code system, according to an AMA spokesman. The AMA makes about 3,500 edits to CPT codes each year, the spokesman said.
CMS incorporates CPT-4 codes as its Level I HCPCS coding system. Level II HCPCS codes are for those procedures, goods and services not covered by Level I codes.
For more information about the changes in HCPCS procedures and an Oct. 27 "open door" session to explain them, see cms.hhs.gov.