On Oct. 1, doctors and hospitals must adopt thousands of new billing codes in order to get paid by Medicare, but the timing couldn’t be worse, as that might be the first day of a government shutdown.
If a shutdown happens, officials with the Centers for Medicare and Medicaid Services are completely unsure of how it will affect efforts to coordinate the transition to the new codes.
“We just don’t know honestly,” said Dr. William Rogers, the ombudsman for the agency’s effort to switch to new billing codes, on a call with reporters Thursday. “We don’t have a lot of experience with this and there are different legal issues about what are emergency operations and what aren’t.”
Agency officials said Medicare will continue to pay for claims that are made during a shutdown, which could occur over whether to defund the women’s health and abortion provider Planned Parenthood.
But it remains unclear how much help doctors and hospitals can expect to get from the agency if a shutdown occurs.
The agency will still have some core customer service and provider service functions since those are considered essential, said Patrick Conway, the principal deputy administrator for CMS.
There is a lot of information for doctors and hospitals to sift through. The current coding system has about 14,000 codes that doctors will use to get reimbursed for different medical services.
But that will shift to more than 50,000 codes. The goal is to provide more specificity for the coding system, which is called ICD-10, and provide an update since the last coding system was put in place in the late nineties.
Some lawmakers believe it will create confusion and other problems for doctors.
“With 56,000 more new mandated codes, ICD-10 will require extensive training for providers and their staff. That’s time away from patients,” according to an op-ed from Reps. Tom Price, R-Ga., and Ted Poe, R-Texas, in the Washington Examiner in July.
