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Doctors Cheer As Feds Delay New Disease Codes, Again

Dolphin bite? There's a medical code for that.
Simone Di Tonno - Annachiara Fig
Dolphin bite? There's a medical code for that.

Poking fun at a complex new system for classification of diseases is surprisingly easy and enjoyable.

Yes, there are codes your doctor will be able to use someday to submit bills for treatment of a dolphin bite (W5601XA), being struck by a dolphin (W5602XA) or "other contact" with a dolphin (W5603XA). And that's just the start.

Thousands of detailed codes form the backbone of a billing system that the federal government has been seeking to modernize for a while. The U.S., unlike other countries, is still using old codes.

But it's going to take a while longer before things change. The Department of Health and Human Services said Thursday it's delaying implementation of the ICD-10, short for International Classification of Disease, 10th Revision.

Many doctors had raised a ruckus about the inconvenience and expense of switching to ICD-10 when so many other things are changing in health care.

The regulations requiring the move were published three years ago, and were set to take effect in Oct. 2013, two years later than originally planned.

Even so, the American Medical Association, among others, has argued the regulatory burden imposed on doctors by ICD-10 is heavy and is inconsistent with President Obama's executive order telling federal agencies to look for ways to reduce bureaucratic headaches.

An AMA letter (sent on Groundhog Day) to HHS Secretary Kathleen Sebelius laid out the doctors' case. And today Sebelius saw it the AMA's way. A new deadline will be set in a future, but unspecified, round of regulation-writing.

Perhaps not surprisingly, the AMA praised the delay. "The timing of the ICD-10 transition could not be worse for physicians as they are spending significant financial and administrative resources implementing electronic health records in their practices and trying to comply with multiple quality and health information technology programs that include penalties for noncompliance," Dr. Peter Carmel, president of the American Medical Association, said in a statement.

The delay is likely to irk hospitals and insurers who've spent a lot of dough on getting ready for the ICD-10 system, since HHS has said the 2013 deadline was for real.

"Sounds like the lowest common denominator in the health care system wins out," health industry consultant Bob Laszewski wrote in a blog post. "It was obvious a year ago that the docs ... weren't going to be ready yet [the Centers for Medicare and Medicaid Services] kept telling everyone to keep spending big money on all of this."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Scott Hensley
Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.