Message from the CPC Chair
Over the past two months, ASCO has solicited information from you about your implementation problems during this transition to the new Medicare coding system. ASCO has brought your issues to the attention of CMS and the Medicare carriers and has been working with them to resolve many of the problems.We know and appreciate that many of you have also worked with the carriers and CMS on these same issues.
Although many of the carrier problems have been resolved, we understand that there is still confusion about how to code and file claims under the new system.ASCO has compiled a comprehensive
“Frequently Asked Questions” document to help with some of those difficult issues.
We are still waiting for clarification from CMS on some issues, but the FAQ document includes questions from practices across the country for which we have received answers from CMS and the carriers.We hope this document helps you navigate the new system, and we will continue to update this document as we get more information.
We need to know what problems you are still having implementing this new system.Please call the ASCO reimbursement hotline at 703-299-1054, or send a detailed email to
publicpolicy@asco.org.
ASCO also will hold teleconferences in the near future, to provide information from CMS once it is forthcoming and to address your questions and additional concerns.
MMA in the Spotlight
Talking to Patients about the Changes
As practicing oncologists, ASCO knows that your greatest priority is making sure that your patients have access to high-quality cancer care. Some of your patients may be asking you questions about changes in their Medicare co-payments.
ASCO has collaborated with the National Coalition for Cancer Survivorship to write a
letter that you may wish to provide your patients to help them understand these changes. ASCO encourages you to put this on your practice letterhead and recommends that you personalize your letter as you feel appropriate.
News and Notes
ASCO’s Reimbursement Hotline
If you need help with the new coding changes or the demonstration project, please contact ASCO’s Reimbursement Hotline at 703-299-1054 or via email at
publicpolicy@asco.org.
Research UpdateThe Office of Inspector General (OIG) of the Health and Human Services Department and the Medicare Advisory Commission (MedPAC) are required by law to study the effect of the new reimbursement system on oncology. Those studies are ongoing and will be reported to Congress late this year or early 2006. ASCO has met with both the OIG and MedPAC to ensure that those studies fully represent the complexities of cancer care. We will update you on the progress of these reports as we receive information.
IV vs. Push Infusion
Recent instructions from CMS and the Medicare carriers have indicated that infusions of 30 minutes or less be billed as a push. At a meeting in February, AMA recommended that an infusion of less than 15 minutes duration be reported with the appropriate CPT code for the push, and infusions lasting longer than 15 minutes be reported with the appropriate infusion code.
AMA also re-defined an intravenous or intra-arterial push as: An injection in which the healthcare professional who administers the substance/drug is continuously present to administer the injection and observe the patient; or an infusion of 15 minutes or less.
Click here to view a synopsis of this action, as well as other actions related to the drug infusion codes.
ASCO has been communicating regularly with CMS since the AMA issued its recommendation, to encourage CMS to adopt language that will be consistent with the AMA. ASCO also is working to ensure appropriate and accurate coding for services provided to cancer patients.
