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1 2014 NEWSLETTERS April 2014: Volume #3 2014, Issue 134 ICD-10 on Hold Documenting Rate Increase Review of System Documentation Frequency Analysis Level of Decision-Making February-March 2014: Volume #2 2014, Issue 133 Simulation: Proper Coding 2014 Roadmap to Documentation Clinical Treatment Planning January 2014: Volume #1 2014, Issue Updates Final Conversion Factor and Rates Simulation in 2014 Proper Use Choosing the Simulation Level What Services Does the Simulation Description Include? Defining Complex Blocking or Custom Shielding Blocks How to Report & Document Respiratory Motion Simulation 2013 NEWSLETTERS Mid Course Simulations or CT Data Acquisitions Brachytherapy Simulation vs. 3D Brachytherapy Isodose Planning Packaging vs. Bundled Packaged Service Status Indicators Stereotactic Radiosurgery No More G-Codes December 2013: Volume #8 2013, Issue 131 OPPS One Room Charge MPFS Conversion Factor (Still Pending) 2014 OPPS Conversion Factor - $ Summary of Simulation Reimbursement OPPS Packaging Proposal Abandoned Sample Prostate Reimbursement Changes Meaningful Use Implementation Delayed G-Codes Gone for SRS/SBRT Procedures Comparison of Rates Supervision Nonenforcement Policy Expires in 2013 November 2013: Volume #7 2013, Issue Final Rules Released DIBH is not 4D Conversion Factor History Compare 4D and 3D Rate comparison proposed 2014 RVU and CF 3D DIBH & Associated Work Qualifying for Will DIBH Work Qualify for a 'Special Code' 4D Scans are Free Breathing During Treatment
2 2013 NEWSLETTERS (continued) August-October 2013: Volume #6 2013, Issue New Code CMS to Look at DOS for MUE 2014 Code Changes Simulations IGRT The Real Rules Device Level: MLC is NOT Always Complex IGRT Orders 2014 Code Changes 3D Qualifying for IGRT 2014: No more G-Codes for Stereotactic June-July 2013: Volume #5 2013, Issue 128 Big Changes Announced (MPFS) OPPS 2014 Proposed Changes How to Report the 'Virtual' in the Sim Process 2013 Status Indicators Simulation and Planning 2014 Status Indicators Comparing Imaging Rates Typical Regimen Flow Sample IMRT Course MPFS Sample Course under OPPS RA Announces IMRT Review APC Rate Changes CMS Approved Audit Issues May 2013: Volume #4 2013, Issue 127 Simulation Coding Summary How to Report the 'Virtual' in the Sim Process Who is Qualified to Supervise? March-April 2013: Volume #3 2013, Issue 126 Sequestration and You Cobalt Based SRS Also Cut What the Hospital Impact Is Other Proposals in the Works What the Physician Impact Is Proposed Imaging What Freestanding Impact Is February 2013: Volume #2 2013, Issue 125 Are you Familiar with Your RAC Auditor? Documentation Guideline SBRT Stereotactic Audit Announced Medical Necessity (SBRT) Appropriate Quantities What Does Robotic Mean to You Carrier LCD Policies Limiting SBRT Standard Steps & Codes SRS/SRT/SBRT Co-Surgeons Utilization Guidelines for SBRT January 2013: Volume #1 2013, Issue 124 Conversion Factor Final at $ Compare MPFS Rates Compare APC Rates What Reimbursement Will Look Like in 2013
3 2012 NEWSLETTERS November-December 2012: Volume #9 2012, Issue 121 What Our Rates Will Look Like Sample IMRT Course: Comparing 2013 RVU with both Conversion Factors Sample IMRT Course: Comparing 2013 RVU with 25 CF and 2012 Compare an IMRT Course for 2013 w 34 CF and 2012 Rates Sample 3D Course: Comparing 2013 RVU with both Conversion Factors Sample 3D Course: Comparing 2013 RVU with 25 CF and 2012 Compare 3D Course for 2013 w 34 CF and 2012 Rates October 2012: Volume #8 2012, Issue 122 Are Your Physicians Attending ASTRO? Does Your Carrier Bundle Services w 77301? HIPAA Breaches; How Safe Are You? Date of Service (DOS) for with IMRT CMS Security Guidelines Performance Scale Which Do You Use? How Secure is Your Copier? Wording Variations-Which Do You Use? How Coding Guidelines Vary and/or Change Does Immobilization Define the Sim Level? Who is Your Carrier? Know Your Policy August-September 2012: Volume #7 2012, Issue 121 Meaningful Use Time Line Benefits of EHR Core Measurements 1-15 Roadmap to EHR Goal of EHR Pitfalls of EMR Technology Medicare EHR Incentive Payment Schedule for Supplying EMR Records to Others Eligible Professionals Qualifying for Meaningful Use Organizing & Securing Your PDF July 2012: Volume #6 2012, Issue 120 CY 2013 Physician Fee Schedule (PFS) Proposed Table 1: APC Comparison Conversion Factor & Proposed RVU Table 2: RVU Comparison Major Code Changes Table 3: Rate Comparison 2013 to 2012 with the 2012 CF Side by Side: 3D vs IMRT with 2013 CF Table 4: Rate Comparison 2013 to 2012 with the 2013 CF
4 2012 NEWSLETTERS (continued) June 2012: Volume #5 2012, Issue 119 What is the Correct Date of Service? Attestation Document o What Constitutes a 'Week' o Physician Attestation Section Sample o Personnel Performing o DOS is Clear o Services With T & P Components o Physician is Clear o DOS for Imaging Control Points (Not Reportable) o DOS for Isodose Planning o Basic Dosimetry for Control Points o E-Signature Authentication o Devices for Plans with Control Points o E-Signature Attestation IMRT Basic Dosimetry o Signature Purpose o Signature Integrity April-May 2012: Volume #4 2012, Issue 118 Documentation Requirements Written Directive Parameters When are Orders Required Know What You Are Ordering Included in CPT New Codes for Medical Oncology RAC and Quarterly NCCI and ME Changes Guest Article: Written Directive or Order March 2012: Volume #3 2012, Issue 117 Brachytherapy Surgical Placement Codes Clinical Treatment Planning (77263) Collaborating Physician Charges Special Treatment Procedure (77470) Imaging Codes Brachytherapy Simulation Brachytherapy Applications Brachytherapy Isodose Planning Sample LDR Case Brachytherapy Calculations Sample HDR Case Device Codes February 2012: Volume #2 2012, Issue 116 Simulation and Isodose Planning Processes Conventional Simulation ( ) Simulation Simulation on a Dedicated CT Equipment Pre-Planning Simulation (77290) Virtual Process Block Verification Simulation (77280) Test Your Simulation Notes IMRT Simulation Levels ( ) Reporting CT data acquisition Isodose Planning Processes Planning Volumes Two dimensional planning Simulation Quantities = 1 per Day Special Teletherapy Port Plan Documentation for Simulation Three dimensional planning Device Quantities IMRT planning January 2012: Volume #1 2012, Issue 115 CY_2012 Final Rates Compared to 2011
5 2011 NEWSLETTERS November-December 2011: Volume #7 2011, Issue 114 Calculating Physician Payment (MPFS) PQRS Incentive Program Rates for High Volume Services Decrease: 2012 APC Changes for 2012 Compare 2012 to 2011 Rates Links for the Final Rules Misvalued Codes: 2012 Links for 2012 Work Plan PQRS Final Changes to Payment Rates under the OPPS in CY 2012 September-October 2011: Volume #6 2011, Issue 113 Code Change: Special TX Procedure (77470) Verbal Orders: Timeframe Requirement Treatment Management: Description Changes Consultations: Timeframe Requirement Providing Records to Patients in EMR World July-August 2011: Volume #5 2011, Issue 112 Reimbursement Code CMS Medicare Claims Processing Manuals Proper Use of Modifier 59 Medicare Claims Processing Manual: Chpt 23 Documentation for Separate and Distinct OIG: Use of Modifier 59 to Bypass CCI Edits CMS Identifies Incorrect Use of Modifier 59 to Bypass CCI Edits Hospital OCE Code Editor NCCI Edit Overview DOS for Reporting NCCI Edits Physicians Reporting for IMRT NCCI Edits Hospital Outpatient PPS What Constitutes a 2nd Algorithmic Calc? Medically Unlikely Edits 2012 MPFS Update Released May-June 2011: Volume #4 2011, Issue 111 IGRT: 'This Treatment'/ 'Next Treatment' Authentication Verbal Orders Date of Service (DOS) Cloned Medical Notes Date of Service in EMR E-Prescribing Incentive Deadline: June 30 Authenticating Records March-April 2011: Volume #3 2011, Issue 110 What Codes ARE they Looking At? Preparing Your IGRT Documentation February 2011: Volume #2 2011, Issue 109 What are Edits? Mutually Exclusive Codes NCCI Edits Medically Unlikely Edits (MUEs) Modifier Column What is a Week Modifier '0' Introduction: Guest Columnist Modifier '1' What Constitutes IMRT Planning Appropriate Modifiers Editor's Notes on IMRT NCCI Policy Manual January 2011: Volume #1 2011, Issue 108 January 11, 2011 CMS Final Rule
6 2010 NEWSLETTERS December 2010: Volume #9 2010, Issue 107 President Obama Signs Act Isodose Planning & Devices Budget Neutrality (BN) Management Conversion Factor $ Treatment Final RVU for 2011 IGRT Imaging Final APC Rates for : A Year in Review Work RVU: 3.37 Supervision 2011 Rates for Common Codes 2011 OIG Work Plan November 2010: Volume #8 2010, Issue 106 Code Changes for 2011 Utilization Federal Register-With Comments Compare & September-October 2010: Volume #7 2010, Issue 105 New Codes for 2011 Coding Errors CERT Supporting E&M Services Error Categories Imaging Accreditation August 2010: Volume #6 2010, Issue 104 Remote IGRT Images Off-Site IMRT Plan with IMRT Boost EBRT Documentation Requirements IMRT Plan with Photon Boost June-July 2010: Volume #5 2010, Issue 103 Reimbursement Increase in Effect Code Reimbursement Comparisons CCI Edit Changes May 2010: Volume #4 2010, Issue 102 Signature Guidelines & Requirements IGRT: When It Qualifies Physician of Record Continuing Extension Act 2010 April 2010: Volume #3 2010, Issue 101 Tracking Organ Motion Inter-Fraction vs Intra-Fraction Placing Interstitial Markers Intra-Fraction Target Tracking March 2010: Volume #2 2010, Issue 100 Hold Claims until March 10, 2010 Documenting Consults January 2010: Volume #1 2010, Issue 99 HDR Brachytherapy Not 77421, or Not Reportable Stereoscopic Imaging
7 2009 NEWSLETTERS December 2009: Volume # , Issue 96 Interim CF Established Utilization IMRT Device Code Rates Posted on Website Summary of 2010 Code Changes E&M Services and CCI Edits Updated November 2009: Volume #9 2009, Issue 92 Final Rules Released E/M Crosswalk: Outpatient Sample Code Rates E/M Crosswalk: Inpatient IMRT Device Code Office Visits Bundle Radiation Services Rate for Compare Office Visits to Consultations Medicare Removes Consultation Codes Data Reviewed October 2009: Volume #8 2009, Issue 91 Code Changes Wording Revised New IMRT Device Code (77338) EMR Medical Records New Interstitial Placement Codes 2010 Cross Over Codes Different Modalitites September 2009: Volume #7 2009, Issue 90 When is it a Consultation? LMRP vs. LCD Carrier Policies August 2009: Volume #6 2009, Issue 89 CT: 3D or Portal Design Simulation Documentation Physician Availability July 2009: Volume #5 2009, Issue 88 Supervision Change Code MAC Fiscal Intermediary (Part A) Carriers (Part B) May-June 2009: Volume #4 2009, Issue 87 Red Flag Rules Fusion March-April 2009: Volume #3 2009, Issue 86 Clinical Treatment Planning Documentation a MUST for 77336! Written Carrier Rulings SBRT Daily Note Number of Simulations Per Course Simulation Levels Immobilization LCD vs. LMRP Know Your Policy Written Carrier Rulings Denial Notices from Carrier CT Data Acquisition not always 3D IMRT Planning Does NOT Support 77470
8 2009 NEWSLETTERS (Continued) January February 2009: Volume #2 2009, Issue 85 EHR, Soon to be a Requirement Supervision December 2008/January 2009: Volume #1 2009, Issue 84 High Dose Rate (HDR): 2009 Changes What you can do about Supervision Stereotactic Radiosurgery Intra-Fraction Localization
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The following references are used throughout the billing scenarios that follow:
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