Oncology & Hematology Coding Alert

Nuclear medicine doesn't fare as well

CMS has RVU changes in the works. Oncology practices face good and bad news. See what your specialty can expect:

E/M update: To cover the cost of increasing work RVUs for E/Ms (and some procedures), CMS plans to cut all non-E/M work RVUs by 10 percent across the board. This -budget neutrality adjustment- will affect every code that has physician work RVUs. And CMS says there may be further -adjustments- announced later this year.

-The problem with this is it gives with one hand and takes with another, because of the budget neutrality,- says Barbara McAneny, an oncologist with New Mexico Oncology and Hematology Associates in Albuquerque. Medicare should recognize that physicians are cutting costs in hospitals by doing more things in their offices, McAneny adds. Instead, hospitals get pay hikes every year and physicians have spending caps.

To get a look at the proposed RVU changes, head to the June 29 Federal Register, available online at www.setonresourcecenter.com/Register/2006/Jun/29/37170A.pdf.

Brachytherapy: CMS proposes to give brachytherapy codes 77781-77784 (Remote afterloading high-intensity brachytherapy ...) -XXX- global periods to allow you to bill separately for each treatment session. But CMS will lower the work RVUs for those codes to reflect that you can bill separately for a post-operative visit. Note: This proposal affects brachytherapy codes only--not external beam radiation codes.

Demonstration project: The 2006 demonstration project for reporting on some measures of quality will expire in 2007, unless CMS takes action to renew it or initiate a new demonstration.