By Corbin Johnson, MD, CUAC chair, and Nikhil Thaker, MD, CUAC vice-chair
As radiation oncology heads into 2020, are you worried about whether your practice has its coding compliance in order and is up to speed on new coding rules? ASTRO, the authority on radiation oncology coding, is rolling out an updated ASTRO Radiation Oncology Coding Resource and hosting a Coding and Coverage Seminar to help practices get off to the right start in the new year.
ASTRO’s Code Utilization and Application Committee (CUAC) works throughout the year to ensure that the radiation oncology (RO) community has access to comprehensive tools that assist with consistent application and interpretation of the Current Procedural Terminology (CPT®) code set most commonly used in RO. The CPT system, developed by the American Medical Association (AMA), is a highly technical process. New codes are developed, redefined and revalued every year for physicians and other qualified health care providers to report services provided in a universal manner to institutions, private and government payers, researchers and other interested parties. ASTRO actively provides input to the AMA and other groups that update the CPT coding system to ensure that CPT coding accurately reflects the clinical logic and level of effort that is required in RO.
Annual Coding and Coverage Seminar and Resource
CUAC’s primary responsibility is to understand the impact of these changes on coding for radiation oncology services. This includes providing membership with educational programs and materials that include the most recent and up-to-date coding guidance. One of the most popular educational programs that ASTRO offers to the RO community is the annual Coding and Coverage Seminar. This two-day seminar held at ASTRO headquarters provides a comprehensive overview of the many factors that affect the complex and ever-changing aspects of coding in clinical practice. The seminar is geared to make clinical coding easier to understand and applicable to those new to coding as well as for those with experience who are looking to hone their skills. This year’s seminar will take place on December 6 and 7 in Arlington, Virginia. Registration is currently open on the ASTRO website.
In addition to the seminar, CUAC also produces the ASTRO Radiation Oncology Coding Resource. The Coding Resource is designed as an orientation and reference document to assist physicians, their practice administrators and their staff to develop accurate coding and documentation procedures to support billing for RO services. The ASTRO Radiation Oncology Coding Resource is an essential coding reference for all radiation oncology practices, and ASTRO strongly encourages all coding/billing professionals to utilize this resource in their daily practice. This resource is updated twice a year to ensure that it reflects the most up-to-date information on CPT coding, rules and regulations related to radiation therapy. Coding and Coverage Seminar attendees will receive a copy of the updated Coding Resource as part of their registration.
Additional ASTRO coding resources
In addition to the comprehensive ASTRO Coding Resource and annual Coding and Coverage Seminar, ASTRO provides the RO community with coding education through regularly updated coding FAQs, Coding Guidance Articles and Coding Updates on the ASTRO website. If ASTRO members have coding questions that are not answered through these various resources, or if further clarification on a nuanced topic is needed, they are encouraged to submit the question through the ASTRO Coding Question submission form. The questions submitted through the Coding Question submission form are processed through CUAC during their monthly meeting, and members are provided an answer to their questions via email. While providing individualized coding guidance to members, this question form also enables CUAC to keep track of frequently asked questions and topics that may have significant importance to the membership at large.
It's important to remember that correct coding encourages efficiency, reduces audit risk and claim rejections and facilitates efficient reimbursement. Additionally, accurate coding and proper supporting documentation demonstrate an understanding of the process and delivery of patient care. While correct coding reflects the process of care, it is vital to acknowledge that coding does not drive the process of care. Selection of codes should not be based on reimbursement but rather on the services provided by the physician that are considered medically necessary while caring for the patient. The physician of record is held responsible not only for all aspects of patient care but also for all codes and documentation submitted in his or her name. Arming yourself with a thorough understanding of these key elements and taking advantage of ASTRO’s educational resources can lead to successful practice management.
Corbin Johnson, MD is a radiation oncologist at Vanderbilt University Medical Center. Dr. Johnson currently serves as chair of ASTRO’s Code Utilization and Application Subcommittee in addition to playing a vital role as a member of ASTRO’s Code Development and Valuation Subcommittee.
Nikhil Thaker, MD, is a radiation oncologist with The Arizona Oncology Associates of Tucson and currently serves as vice-chair of ASTRO’s Code Utilization and Application Subcommittee, as well as serving on the Code Development and Valuation Subcommittee.