History & Role
The AHA Central Office was created through a written Memorandum of Understanding between the American Hospital Association (AHA) and the Centers for Disease Control and Prevention (CDC) in 1963 to:
- Serve as the U.S. clearinghouse for issues related to the use of ICD-10-CM and ICD-10-PCS (and previous use of ICD-9-CM)
- Work with CDC and the Centers for Medicare and Medicaid Services (CMS) to maintain the integrity of the classification system
- Recommend revisions and modifications to the current and future revisions of the ICD
- Develop educational material and programs on ICD-9-CM
The Central Office on ICD-10-CM and ICD-10-PCS represents a long-standing public and private sector collaboration between the Department of Health and Human Services (HHS) and:
- American Hospital Association (AHA)
- American Health Information Management Association (AHIMA)
- Centers for Medicare and Medicaid Services (CMS)
- Centers for Disease Control and Prevention (CDC)
In January 2001, the AHA Central Office on Healthcare Common Procedure Coding System (HCPCS) was developed to provide consistent and accurate advice to hospitals for appropriate and effective application of the HCPCS classification system. This new service provides coding advice and publishes a quarterly newsletter to address HCPCS (Level I CPT and certain Level II national HCPCS) related issues for institutional providers.
In August 2005, CMS and AHA entered into an agreement for the establishment of an AHA clearinghouse for issues related to the use of certain HCPCS codes. Under this agreement, responsibilities of the AHA Central Office includes providing advice on the following:
- Level I HCPCS (CPT-4 codes) for hospital providers
- Certain Level II HCPCS codes, specifically: - A-codes for ambulance services and radiopharmaceuticals - C-codes - G-codes - J-codes - Q-codes, except Q0136 through Q0181 for hospitals, physicians and other health professionals who bill Medicare.
The AHA Clearinghouse will not respond to the following related to HCPCS codes:
- Inquiries from physician providers related to CPT-4. These questions should be directed to the American Medical Association (AMA).
- Questions related to A-codes, except those for ambulance services and radiopharmaceuticals, and Q-codes Q0136 through Q0181. These questions will be referred to the Statistical Analysis Durable Medical Equipment Regional Carriers (SADMERCs).
- The remainder of the body of Level II HCPCS codes related to durable medical equipment, prosthetics, orthotics, and other supplies should be directed to the Durable Medical Equipment Regional Carriers (DMERCs) or their successors, the DME Medicare Administrative Contractors (MACs). These codes do not apply to hospital or physician providers.
The AHA Central Office has five main roles:
- Represents and serves AHA members at the national level by promoting uniformity of health care data by collaborating on the establishment of coding and classification standards (ICD-9-CM, ICD-10-CM/PCS) and guidelines across health care settings.
- Identifies and resolves coding and classification needs of members, provides expert advice by serving as the clearinghouse for the dissemination of coding information to members and other users of clinical data.
- Represents AHA institutional members needs by recommending revisions to the Centers for Medicare and Medicaid Services (CMS), and Centers for Disease Control and Prevention (CDC) that ensure that the classification remains current, viable and robust.
- Provides educational coding products so that providers have well-trained, well-informed coders to allow appropriate capture of information.
- Is involved in endeavors that rely on the use and interpretation of data including development and implementation of standards in the inpatient and outpatient setting, home care as well as rehabilitation because the classification system is at the core of the information infrastructure.