Payment reform is a vast, quickly changing subject that is becoming increasingly important with the emphasis on quality outcomes. Currently, the only educational materials specific to QPP and radiation oncology are the resources posted on the ASTRO website.

CMS’ Quality Payment Program (QPP) as established by MACRA, completely changes the way that radiation oncologists receive reimbursement through Medicare. This program is complex and cumbersome, and there are limited educational resources for radiation oncologists. The program will provide education on MACRA and QPP as related to the specialty of radiation oncology and will give valuable information of the changes to come as QPP unfolds.

Participants will learn common mistakes in coding related to the radiation oncology code set as well as the Center for Medicare and Medicaid’s (CMS) Quality Payment Program (QPP).

Upon completion of this live activity, attendees should be able to do the following:

1. Avoid common errors in relation to radiation oncology coding.
2. Explain the basics of payment reform as outlined under QPP.

Both Brachytherapy and Proton Beam Therapy (PBT) are unique modalities within radiation oncology. This Brachytherapy and Proton Beam Therapy session within the ASTRO Coding and Coverage Seminar will cover these two modalities in detail, including both coding and coverage for Brachytherapy and Proton Beam Therapy. ASTRO’s Proton Beam Therapy Model Policy will be reviewed in detail.

Upon completion of this live activity, attendees should be able to do the following:

1. Explain the complexities associated with Brachytherapy and PBT.
2. Identify and use the codes associated with each of these modalities.
3. Correctly code for Brachytherapy and PBT all will understand the complexities associated with these code sets.

Both 3-D and IMRT are both frequently used modalities within radiation oncology. Currently, there is a large knowledge gap in coding regarding the differences between 3-D and IMRT. This session within the ASTRO Coding and Coverage Seminar will cover these techniques in detail, including both coding and coverage. Participants will learn the differences as it related to clinical work and coding for forward planning, inverse planning, compensators, and the “Choosing Wisely” criteria.

Upon completion of this live activity, attendees should be able to:

1. Summarize the differences in coding for forward planning and inverse planning for IMRT and 3-D courses of treatment.

The Case Studies within ASTRO’s Coding and Coverage Seminar will be interactive sessions where participants can try hands-on coding as well as ask question in real time. Currently, there are no other known interactive case study sessions within the radiation oncology coding community.

In this case study at ASTRO’s Coding and Coverage Seminar, a breast cancer case will be discussed in which 3-D with boost is utilized. Participants will have the opportunity to engage with faculty ask questions, and problem-solve in real time. A standard course of treatment is discussed immediately before this case study in the Coding and Coverage Seminar Agenda to ensure that a baseline knowledge of billing and coding for radiation oncology is established.

Upon completion of this live activity, attendees should be able to do the following:

1. Discuss billing and coding as it relates to Intensity Modulated Radiation Therapy (IMRT) for breast patients.
2. Code a complex IMRT case independently.

Both SRS and SBRT are unique modalities within radiation oncology. This SRS and SBRT session within the ASTRO Coding and Coverage Seminar will cover these two modalities in detail, including both coding and coverage for these modalities.

Participants will learn the differences between Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiosurgery (SBRT). Clinical indications and the code set for SRS and SBRT will be addressed. Nuanced details of coding across SRS and SBRT will be discussed.

Upon completion of this live activity, attendees should be able to do the following:

1. Identify and distinguish the codes necessary for SRS and SBRT courses of treatment.
2. Correctly code for SRS and SBRT all will understand the complexities associated with these code sets.

Significant changes are planned for the E/M CPT code set for 2021 for new and established office and outpatient codes. This session will inform participants how to use time for new and established patients in 2021, define the key terms in the revised medical decision-making guidelines, and plan how to implement these changes in their practice.
 
Upon completion of this live activity, attendees should be able to do the following:

1. Avoid common errors in relation to radiation oncology coding.
2. Explain the changes with the E/M CPT code set that are planned for 2021.
3. Define key terms in the revised medical decision-making guidelines.
4. Plan how to implement these changes in their practice.

Participants will learn common mistakes in coding related to the radiation oncology code set as well as issues related to Packaging and Bundling. Participants will also learn when and how to appropriately use NCCI Edits with the radiation oncology codes.

Upon completion of this live activity, attendees should be able to do the following:

1. Avoid common errors in relation to radiation oncology coding.
2. Correctly use and apply NCCI edits.
3. Discuss packaged and bundled code sets.