Ohio Board of Pharmacy Rule Moves Forward with ICD-10 Compromise

The State of Ohio Board of Pharmacy (BOP) rules requiring prescribers to report the ICD-10 code and specific condition for an opioid prescription have been through the appropriate review process and will be implemented in the near future; however, there will be a delay in implementation for certain parts of the rule.

The BOP rules require prescribers to include the ICD-10 diagnosis code when documenting the prescription of a controlled substance in the Ohio Automated Rx Reporting System (OARRS). The AMCNO joined the Ohio State Medical Association (OSMA) and other healthcare associations across the state in expressing our concerns that this requirement would cause an administrative burden for prescribers, because the ICD-10 system includes a large number of codes for very specific conditions.

Although the AMCNO fully supports the efforts of the State Medical Board of Ohio (SMBO) to develop acute pain prescribing rules, as well as Gov. John Kasich’s initiatives to tighten up the prescribing regulations for opioids when treating acute pain, we expressed concern that the BOP rule goes above and beyond the intent of these efforts, considering these rules address more than just prescribing opioids for acute pain—the rule would have required an ICD-10 code whenever a physician writes a prescription for any controlled substance.

The AMCNO had submitted written testimony to the Joint Commission on Agency Rule Review (JCARR) outlining our concerns, but pulled our testimony after a compromise was reached by the governor’s office, SMBO, BOP, Ohio Hospital Association, and the OSMA. Under the compromise, hospitals and physicians’ offices would report ICD-10 codes on prescriptions for opioids once the rule is implemented, but they would have an additional nine months to begin reporting ICD-10 codes on all other controlled substance prescriptions. This means that the BOP has agreed to adopt a resolution to delay the enforcement of the diagnosis code requirements for opioid drugs for 120 days, to Dec. 29. For non-opioid controlled substances, the requirement will be postponed until June 1, 2018.

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