Doctors would report opioid diagnosis codes of patients under agreement

COLUMBUS » Ohio doctors would report the specific diagnosis of every patient who receives a prescription painkiller under a tentative agreement reached Friday with the Kasich administration.

The 11th-hour compromise between the Republican governor’s office, the state Medical Board and associations representing doctors and hospitals followed months of wrangling over new opioid prescribing rules proposed in April in a state that leads the nation in opioid addiction and death.

A record 3,050 Ohioans died from drug overdoses in 2015, a figure expected to jump sharply once 2016 figures are tallied.

The compromise on prescription reporting was reached in time for a legislative rule-making panel’s scheduled vote Monday.

The disputed rule required prescribers to enter what’s known as an ICD10 code into Ohio’s online reporting database for every controlled substance prescription. The administration argued the reporting mandate was critical to fighting Ohio’s top status for opioid abuse and death.

Under the compromise, hospitals and doctors’ offices would report codes for opioids right away, but they would have an additional nine months to begin reporting all other controlled substances.

Medical Board Director A.J. Groeber said collecting ICD-10 codes — in other words, knowing what conditions doctors are treating using potentially addictive opioids — is “the linchpin” both to effective regulation and education.

“It’s not just about going after the bad actors,” Groeber said. “We want to be able to do that, but we also want to educate the vast majority of our wellintentioned licensees to make sure that they know that they can treat patients effectively with fewer pills and fewer days’ supply.”

Ohio State Medical Association spokesman Reggie Fields said doctors didn’t object to the goal, but to the method for accomplishing it, which they saw as unworkable.

“The bottom-line goal here is to try to improve the opioid prescribing that’s taking place across the state of Ohio, and we are in complete agreement with that,” Fields said. “The only issue we had here was the vehicle that had been proposed to get there was just unfeasible to be able to accomplish, because of the administrative and financial burden.”

Ohio Hospital Association spokesman John Palmer said that was because the list of ICD-10 codes is massive and many doctors’ offices and hospitals are not yet set up to incorporate the relatively new code system into their reporting.

“There are thousands upon thousands of codes, from things like knee replacements to hip replacements to a splinter or an Orca whale bite or a tiger bite,” he said. “So it’s just a whole slew of different diagnoses codes.”