Coding & Reimbursement

Coding and Reimbursement Services

Coding Tip of the Month: May 2023

Specificity in diagnosis is crucial in the documentation and reporting of oncology diseases. One area of frequent confusion is the indication of primary versus metastatic cancer. For a primary cause of cancer caused by a neoplasm, the diagnosis would be reported with a code belonging to the range of C01-76 in Chapter 2 Neoplasms of the ICD-10-CM manual. If the cancer has spread to a secondary site, it should be documented and reported with a code found in the range of C77-79. Documentation should specify where both primary and secondary sites of neoplasm are located (unless they are unknown).

Important Updates to Evaluation and Management Services in 2023

The American Medical Association has released the new guidelines for Evaluation and Management (E/M) services which will go into effect on January 1, 2023. The guidelines have been updated to bring all the services in line with the 2021 Evaluation and Management changes to office and outpatient E/M CPT codes. More information regarding CMS’ take on the 2023 E/M changes can be found in the 2023 MPFS (Medicare Physician Fee Schedule) Proposed Rule. See ASCO’s summary.

Check this page frequently for more updates and resources.

Coding and Reimbursement Updates


Evaluation & Management Services Changes

2021 Office and Outpatient Evaluation & Management Services Changes

Coding & Reimbursement Questions?

ASCO members can submit inquiries related to coding, reimbursement, or coverage via email. ASCO staff will respond to your question in a timely manner.