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Report on evidence-based quality measures and receive performance scores via the Quality Oncology Practice Initiative (QOPI®).

Oncology Practice Insider

ASCO’s Oncology Practice Insider provides the latest news, information, and educational tools to assist with the successful management of oncology practice and the delivery of high quality patient care. OPI offers updates on ASCO programs, services, and cancer-related health policy, Medicare news, and billing and coding best practices. To sign up for the biweekly Oncology Practice Insider newsletter, please complete this form.

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In 2021, office and outpatient E&M Services are selected based on either time or medical decision making. As a reminder, to choose the appropriate CPT code based on medical decision making, two of three elements of medical decision must be met or exceeded:
Learn more about Prolonged Evaluation and Management Services in a new webinar. This presentation provides an overview of the changes to Prolonged Services in 2021, how they function, and tips for picking the appropriate CPT code. Questions regarding Prolonged Services (or any other billing and coding inquiries) can be sent to ASCO staff at billingandcoding@asco.org.
In 2021, office and outpatient Evaluation and Management Services are selected based on either time or medical decision making. As a reminder, to choose the appropriate CPT code based on medical decision making, two of three elements of medical decision must be met or exceeded:
To address commonly asked questions regarding the Evaluation and Management (E/M) Services in 2021, the American Medical Association (AMA) CPT Editorial Panel has made amendments to the E/M Guidelines for 2021 document. This document can be found on the AMA’s CPT Evaluation and Management website, along with other tools and resources.
The Centers for Medicare and Medicaid (CMS) issued a new Medicare Learning Network Matters Special Edition Article on billing for services when Medicare is a secondary payer. Learn what to do when the diagnosis codes on a current claim are the same, or within the same family, as the diagnosis codes on the Liability, No-Fault, or Workers’ Compensation Medicare Secondary Payer record, but the service is not related. Learn more. 
In 2021, the Centers for Medicare and Medicaid Services (CMS) will use the medical record documentation to determine the medical necessity of an Evaluation and Management (E/M) Office and Outpatient visit (99202-99215). Reviewers will be looking at the accuracy of the documentation regarding the time spent, if the evaluation and management service is selected based on time. Documentation should include either a start/stop time or a statement regarding total time.
ASCO has compiled resources from federal agencies and state health departments for oncology professionals to access rapidly changing information on the COVID-19 pandemic. This includes a Coronavirus Billing and Coding Guide.
Consultations, Hospital Inpatient Services, Hospital Observation Services As of January 1, 2021, CPT codes 99202-99215 should be selected either based on time or medical decision making. However, the new guidelines do not apply to other E/M services such as consultations, hospital inpatient services, and hospital observation services. Be sure to review the new guidelines in the AMA CPT® Professional Edition manual. Prolonged Services