AAFP asks CMS to clarify new patient relationship codes — 5 things to know

In an Aug. 12 letter, the American Academy of Family Physicians requested CMS restructure the proposed patient relationship codes of continuing care, acute care as well as acute care or continuing care.

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CMS’ proposal places a primary care physician in the “continuing care” category, with other physicians representing the other patient relationship areas. CMS noted their codes require distinguishing physicians based on patient relationships, which could be challenging.

Here are five things to know:

1. The AAFP said they continue to back the Medicare Access and CHIP Reauthorization Act, however, they need additional details about the patient relationship categories and the associated codes.

2. Specifically, the AAFP points out a primary care physician could easily fit into multiple relationship categories.

3. The academy is concerned the complicated proposal will put more administrative and reporting work on already burdened physicians.

4. As many physicians already experience confusion when choosing among multiple applicable codes for a claim, another complicated factor won’t ease the time they spend on administrative work.

5. CMS will not mandate patient relationship codes until 2018 claim forms.

“Patient relationship categories must be mutually exclusive in a given situation, so a physician does not have to choose among two or more equally applicable categories for a patient in a particular circumstance,” the letter read.

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