California Oncology Weekly
"Where California Oncologists Go For Answers!"
A publication of the
Medical Oncology Association of Southern California, Inc.
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This
Weekly
's Hot Topics
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- Gov. Newsom's plan on how the state will decide to lift restrictions California News
- Claims rejected due to improper coding of place of service. Noridian News
- Answers to members regarding telehealth billing. MOASC News
- Take survey for Hematologists and Oncologists to learn how COVID-19 is impacting practices. ANCO News
- NIOSH releases new webpage on COVID-19 and protection of workers. National News
- Sequestration 2% payment adjustment is suspended CMS News
- Register for COA VIRTUAL Conference: Focusing On The Future Together Affiliate Association News
- Bristol Myers Squibb has committed $1 million towards the COA/CancerCare Patient Transportation Fund. Industry News
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- Last Thursday, the newly formed Senate Special Budget and Fiscal Review Subcommittee on Covid-19 Response held its first hearing. Testimony was provided by the State Department of Finance here, the Legislative Analyst's Office here, and the California Budget and Policy Center. As a result of California's Covid-19 response, the state has moved from a substantial budget surplus to a state "budget problem." Both the Department of Finance and LAO testified that our actual budget picture is not yet clear and will evolve over the next few months as data becomes available. You can watch the hearing at www.assembly.ca.gov. California's legislative leaders extended the emergency recess until May 4. In light of the efforts to combat the spread of COVID-19, the legislature will recess for another two weeks.
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Physician practices around the state are facing new realities, and a host of new questions, about employee protocols.
To help physicians understand the rapidly evolving personnel and other employment-related issues during the COVID-19 public health emergency, the California Medical Association (CMA) has published the CMA COVID-19 Toolkit for Physician Employers.
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The importance of telehealth has been highlighted during the COVID-19 pandemic.
Telehealth increases access to care and is especially needed in Medi-Cal. However, there has never been a study to explore the extent to which Medi-Cal managed care plans (MCPs) are making telehealth available to their 10 million members. This survey, conducted in 2019, provides a first look at the telehealth landscape among Medi-Cal MCPs, as well as insight into the priorities, approaches, and challenges of MCPs in offering telehealth.
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Coram, CVS Health's infusion care business, will help transition eligible IV-therapy patients out of the hospital and other care settings by providing in-home nursing.
Coram has enhanced its existing home infusion capacity and capabilities to work with hospitals and providers, including UCLA Health, to support solutions for creating much-needed hospital bed capacity during the pandemic. This includes enhanced clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies. In California, the state is working to add 50,000 hospital beds to make enough room for anticipated COVID-19 patients. https://www.biospace.com/article/releases/cvs-health-works-with-ucla-health-and-other-hospitals-to-help-create-bed-capacity/. Read COA's comments regarding this issue below, in Affiliate Association News section.
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Recent Announcements Published to "Latest Updates" of Medicare Jurisdiction E Part B.
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Medicare received a high volume of paper CMS-1500 claim forms for telehealth services with dates of service during the public health emergency (PHE) these claims were rejected because they are improperly coded with two different place of service (POS) codes on one claim (example 11-office, 02-telehealth).
The CMS-1500 paper claim form cannot contain more than one POS. This rule does not apply to electronic (837) claims.
If you are offering telehealth services as part of the PHE, those claims should be submitted with the POS from where the face-to-face service is normally performed (e.g., office POS 11, hospital POS 21) and include modifier -95 to identify this as a telehealth service during the PHE; this is the preferred method for submission. If you are offering telehealth services as you would under normal circumstances, you may continue to bill your POS as 02 and include modifier -95 to identify that the service was provided during the PHE; which will be paid at the facility fee schedule rate.
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Upcoming Education:
Please see Noridian's schedule of events webpage for upcoming trainings on Telehealth and COVID-19. JEA, JEB, JAF, and JFB
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Advance Beneficiary Notice of Noncoverage Webinar - April 23, 2020.
This event includes: Advanced Beneficiary Notice of Noncoverage (ABN) Overview, ABN Completion, ABN Tips, Noteworthy Information, and Resources
Read the complete update
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MolDX: Decipher Biopsy Prostate Cancer Classifier Assay for Men with Intermediate Risk Disease Final LCD - Effective May 04, 2020.
This Local Coverage Determination (LCD) has completed the Open Public Meeting and Contractor Advisory Committee (CAC) comment period and is now finalized under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV). Responses to comments received may be found as a link at the bottom of the final LCD.
Read the complete update
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- Noridian Medicare Portal (NMP) Self Service Reopenings Webinar - May 5, 2020. This event includes: How to complete a reopening through the NMP, Resources and Reminders
Read the complete update
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Top Denial Code Inquiries and Solutions Webinar - May 13, 2020.
This event includes: Duplicate Claim Denials, Medical Unlikely Edit Denials, Medicare Secondary Payor Denials, Overlapping Claim Denials, MBI Denials, Resources
Read the complete update
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The MOASC Office has been in receipt of inquiries regarding telehealth billing.
Following are the questions and responses. If you are in need of assistance or have any questions, please contact the MOASC Office at moasc@moasc.org or 909-985-9061 x1.
* What are the approved distant sites from which a provider may perform a telehealth service?
Answer: Approved providers may perform telehealth services from any location at which the provider is able to establish an audio/visual communication with a patient and all other standard criteria are met.
* If a provider performs a telehealth service from their home, what is the place of service and correct address on the claim?
Answer: If a provider is performing the service from home due to COVID-19 personal restriction(s) or at the provider's convenience after usual office hours, the address on the claim should be that from which the provider customarily bills services to Medicare. If a provider is performing the service from a home-based office at which they are enrolled with Medicare, then the home-based office address is used on the claim.
* Is there a specific place of service for a telehealth service claim?
Answer:
- Preferred Billing:
For all telehealth services, provider should bill the site of service from which it is performed (e.g., office POS 11, hospital POS 21) and add a
modifier -95
to the service.
- Permissible Billing:
Telehealth claims submitted with POS 02 will continue to process but also require modifier -95.
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MOASC wants to assure their members and colleagues that if the need arises, MOASC Board, Officers & Staff are available to answer any questions you may have. Through this publication and e-mail notices, MOASC has provided COVID-19 related advice regarding telehealth, Cares Act funding, pension plan funding and the nuance of these programs in your practice. PLEASE SHARE YOUR CONCERNS AND ISSUES WITH US at moasc@moasc.org. We wish to help you in any way to get through these challenging times, as we surely will. After all, we are in this together.
Here are links to some useful COVID-19 resources:
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Congratulations to R. Kate Kelly, MD, featured in Clinical Cancer Advances 2020: ASCO's Annual Report on Progress Against Cancer.
This independent review of the field, now in its 15th year, showcases major breakthroughs in clinical cancer research and care, as well as emerging trends in oncology. At the University of California San Francisco School of Medicine, R. Kate Kelley, MD, contributes to research improving Hepatocelluar Carcinoma (HCC). Dr. Kelley received a Conquer Cancer YIA in 2010. Read more: https://www.conquer.org/cancer-research/2020-clinical-cancer-advances
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Congratulations to Mohana Roy, MD, and Ana Velasquez Manana, MD, MS recipients of 2020 ASCO Annual Meeting Merit Award Recipients. The awards are awarded to fellows/oncology trainees whose research is addressed in high-quality abstracts submitted to an ASCO Meeting and recognized for its scientific merit. Dr. Roy is clinical fellow at Stanford Health Care Hematology and Oncology. Dr. Velasquez Manana is Hematology and Oncology fellow at University of California, San Francisco.
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The Association of Northern California Oncologists (ANCO)
is conducting a survey for Hematologists and Oncologists to learn how COVID-19 is impacting their practice. Please take a moment to complete our brief survey: https://forms.gle/5jPTGrGtVeSEujVf9
- The Association of Northern California Oncologists (ANCO) continues to monitor the novel coronavirus (COVID-19) pandemic and is committed to providing the membership the best possible information with which to make clinical and personal well-being decisions.
We encourage member practices to let ANCO know of COVID-19 resources they are depending upon and found useful and how they are responding to COVID-19 and serving their patients and staff at director@anco.org (Use Subject: COVID-19: RESPONSE). Thanks!
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Applications period has been extended for ANCO's Travel Awards to Fellows and Young Clinicians to support attendance at the ASCO Annual Meeting, ASH Annual Meeting, or other national oncology meeting in 2020. The deadline for submission is May 3. Awards will be announced by May 3. Learn more at https://anco.org/membership/fellow-benefits/.
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20th Multidisciplinary Management of Cancers:
A Case-based Approach taking place in Napa on June 19-21. For the more information on the impact of COVID-19 on this meeting go to www.multicancers.org/covid19.html.
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ANCO physician members, their practice staff, and representatives from ANCO's corporate members must register to access password-protected content (e.g., The ANCO Directory, ANCO meeting materials) on the ANCO website www.anco.org.
- Use ANCO's job board to post or search for employment opportunities at ANCO member practices.
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Follow ANCO on Twitter at @ANCO News.
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National News
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In last week's publication of the California Oncology Weekly, we addressed practice's receipt of funds that were deposited, by HHS, directly into practice accounts.
Here is more clarification from HHS directly. HHS COVID Relief Fund
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Physicians who have been allocated a payment from the initial $30 billion general distribution to Medicare providers must sign an attestation confirming receipt of the funds
and agree to the terms and conditions within 30 days of payment. To do that, the U.S. Department of Health and Human Services (HHS) has opened the CARES Act Provider Relief Fund Payment Attestation Portal.
- NIOSH released a new webpage
on COVID-19 to highlight resources available for the protection of workers.
This page provides a centralized resource for new guidance & recommendations produced during CDC's COVID-19 response, as well as pre-existing resources and materials, to promote the safety and health of workers.
Read More.
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With the tax deadline extended to July 15, The IRS wishes to remind eligible taxpayers who haven't filed to look into the Free File options.
Free File online products offer free federal tax return preparation, free electronic filing and free direct deposit of refunds to help get your money faster. Taxpayers whose income was $69,000 or less last year are eligible for the free software. There also is Free File Fillable Forms, an electronic version of IRS paper forms. It has no income limitations. Free File options are available at IRS.gov/FreeFile
to see all Free File options.
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UnitedHealthcare
is taking a number of steps to support you, your patients and your communities during this health crisis.
Highlights of these key actions are summarized:
For Providers -
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expanded telehealth services, their telehealth coding guide *Accelerated claim Learn More, * Member cost share copays, coinsurance and deductibles has been waived for COVID-19 testing and testing-related visits throughout the COVID-19 national emergency period. waive cost share are for:
Office visits, Urgent care visits, Emergency department visits, Observation stays, Inpatient hospital episodes, Acute inpatient rehab., Long-term acute care, Skilled nursing facilities.
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updating our credentialing policies from March 19, 2020 until June 18, 2020 for out-of-network care providers who are licensed independent practitioners and want to participate in our networks. * Reducing Prior Authorization Requirements to streamline operations for providers. Visit our COVID-19 prior authorization page for effective dates and specific details.* Extending Timely Filing Limits for claims with a date of service on or after Jan. 1, 2020. Claims will not be denied for failure to meet timely filing deadlines if submitted by June 30, 2020. This applies to Medicare Advantage, Medicaid, and Individual and Group Market health plan claims. * Helping You with Patient Discharges to SNF Facilities by emailing COVID-19dischargeplanning@uhc.com. This is a dynamic situation, and UHC will continue to post changes and updates on their care provider COVID-19 website. For answers to common questions around billing, claims, and/or eligibility, you can continue to take advantage of our Link self-service tools.
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CMS News
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Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration)
Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.
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At President Trump's direction, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of rules so that hospitals, clinics, and other healthcare facilities can boost their frontline medical staffs as they fight to save lives during the 2019 Novel Coronavirus (COVID-19) pandemic.
These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses. The new waivers sharply expand the workforce flexibilities CMS announced on March 30. For a fact sheet detailing additional information on the waivers announced today and previously, go to:
www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf
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Lessons from the Front Lines
calls are for physicians and other clinicians to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response.
This event is a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. There is an opportunity to ask questions of presenters. This week's Lessons from the Front Lines:
Friday, April 24th at 9:30am -11:00am Pacific. Toll Free Attendee Dial-In: 877-251-0301 Access Code: 5096006.
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CMS Issues New Wave of Infection Control Guidance to Protect Patients and Healthcare Workers from COVID-19.
CMS issued a series of updated guidance documents focused on infection control to prevent the spread of the 2019 Novel Coronavirus (COVID-19) in a variety of inpatient and outpatient care settings. The guidance, based on Centers for Disease Control and Prevention (CDC) guidelines, will help ensure infection control in the context of patient triage, screening and treatment, the use of alternate testing and treatment sites and telehealth, drive-through screenings, limiting visitations, cleaning and disinfection guidelines, staffing, and more.
Press Release
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Affiliate Association News
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- You can still register for the 2020 COA VIRTUAL Conference: Focusing On The Future Together, on April 23-24. A lot of work has gone into this Conference with over 3,000 registered attendees! Check out the virtual Exhibits! COA Conferences help community oncology physicians, pharmacy leaders and business representatives connect the dots across specialties, with a special focus on what is relevant for independent community oncology practices. When practices come together to discuss the important initiatives on a national stage, it drives progress in a way that is truly beneficial to patients. Learn more and register at https://coaconference.com/ View this short video that will open the Conference https://vimeo.com/408992298/a88107928b. Launching right after the Conference, you'll hear more about the COA/CancerCare Patient Transportation Fund and COA/CancerCare Financial Patient Assistance Fund created with CancerCare.
- The Community Oncology Alliance (COA) Board of Directors released a position statement opposing the home infusion of chemotherapy, cancer immunotherapy, and cancer treatment supportive drugs because of serious patient safety concerns. The COVID-19 (novel coronavirus) pandemic has forced all health care providers and care settings to dramatically adjust operations. Independent, community oncology practices have quickly adapted and are taking extreme measures to keep their facilities and providers COVID-19 free so that their patients in active treatment can be assured of a safe environment. The recent, major expansion of telehealth services and relaxation of regulations has provided oncologists with a powerful tool to do this by monitoring patients and ensuring that only those that are in urgent need of treatment come into the practice. Read the OpEd in The Cancer Letter https://cancerletter.com/articles/20200417_7/?fbclid=IwAR1YsAAMxUvARkw3DeOqzlMegSoPzlBdEyvZzmLbrSrLDOgtJurej3t9z9I
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COA has reached out to many corporate members to ascertain their ability to perform virtual visits with COA practices and at the same time provide some much needed sustenance. Several have responded in the affirmative with expected guidelines. Others have expressed offering assistance in other ways. All, to date, can be found here.
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COA has found some organizations that are making various PPE donations for those in critical need.
Certain supplies may be available for donation in coming weeks. This link was created to assist in identifying PPE needs and to facilitate the distribution if, or when PPE these resources become available.
Apply Here.
Please note, application is not a guarantee of fulfillment.
- Join Physicians' Education Resource
®, LLC
, to their 11th Annual International Symposium on Ovarian Cancer and Other Gynecologic Malignancies® a 1-day, educational and scientific LIVE-WEBCAST on May 2, 2020 the meeting will focus on key clinical topics in the management of ovarian cancer, as well as endometrial, uterine, and cervical malignancies. For more information and to register go to
gotoper.com/go/IOG20A
- ASH is accepting nominations through May 31 for the 2020 ASH Advocacy Leadership Institute taking place September 22-23, in Washington, DC. This two-day workshop provides an opportunity for ASH members (who are U.S. citizens) with an interest in health policy and advocacy and a desire to become involved in ASH advocacy activities, to gain a better understanding of the Society and learn about legislation and health policy affecting hematology research and practice. Self-nominations are welcome, and individuals may nominate more than one colleague. For more information and to submit a nomination, visit the ASH website.
- National Cancer Survivors Day® is Sunday, June 7, 2020. Get a jumpstart on planning your NCSD 2020 event by registering it (free of charge) with the National Cancer Survivors Day Foundation at ncsd.org/register. Visit their website at www.ncsd.org. To assist you, NCSD national supporter Coping with Cancer® magazine has put together a list of resources specifically for cancer survivors and caregivers. Follow this link to learn about Coronavirus and Cancer: A list of resources for cancer survivors.
- The International Lung Cancer Congress
will held their 21st Annual meeting on July 23-25, 2020 at the Hyatt in Huntington Beach, and is exclusively extending FREE registrations to MOASC members. This meeting will provide current, practical information on the management of lung cancer, as well as a look at the novel agents and strategies with the potential to shape the future of lung cancer therapy. Leading international and national experts will provide perspectives on how to apply the latest data on targeted agents, immunotherapy, surgery, and radiation oncology in the clinic. To register and to view the invitation click
HERE.
- Cedars-Sinai 3rd Annual Gastrointestinal Tumor Conference is on Saturday, September 12, 2020. Concise and comprehensive updates on the most recent research and advances in immunotherapy for gastrointestinal cancers, will be presented. A stellar faculty has been assembled to share developments in precision medicine, research, and immunotherapeutic approaches to the treatment of cancers of the pancreas, liver, and gastric/esophagus. For more information and to register go to: cedars.cloud-cme.com/gicancercme
- NCCN has published updated guidelines at
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Industry News
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Bristol Myers Squibb
has committed $1 million towards the
COA/CancerCare Patient Transportation Fund. This will allow practices to order a "black car" for patients to and from the clinic. The drivers wear gloves and masks, and the cars are completely cleaned after each ride. A formal announcement will be made on Thursday at their Conference. PLEASE thank BMS for their leadership!!!
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TODAY! AstraZeneca
invites you to their
IMFINZI ES-SCLC National Broadcast that will held on April 21, 2020, with two separate times: 7:30pm ET (6:30pm CT, 5:30pm MT, 4:30pm PT) and 9:30pm ET (8:30pm CT, 7:30pm MT, 6:30pm PT). The speaker is Dr. Mark Socinski, from AdventHealth Cancer Institute, Orlando, FL. To view the invitation click here.
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Attention Clinical Staff! PUMA Biotechnologycordially invites you to their webinar on Wednesday, April 29, 2020 at 5:30pm PDT, Anne O'Dea, M.D. will present, "Protecting Patients with NERLYNX, the only HER2-directed small molecule approved by the FDA in both eBC & mBC." This is not an independent educational program. No CME credits will be provided. Please RSVP to www.moasc@moasc.org or call 909-985-9061 x1.
- Bristol Myers Squibb announces positive topline results from two Phase 3 Trials. The first, is the evaluation of Opdivo® (nivolumab) plus Yervoy® (ipilimumab) vs. Chemotherapy in previously untreated malignant pleural Mesothelioma.
Opdivo plus Yervoy prolonged survival compared to chemotherapy at interim analysis in CheckMate -743. The second, conducted with
Exelixis, of CheckMate -9ER trial evaluating Opdivo® (nivolumab) in Combination with CABOMETYX® (cabozantinib) in previously untreated advanced Renal Cell Carcinoma. This s
tudy met primary endpoints of significantly improving progression-free survival, and secondary endpoints of overall survival and objective response rate vs. sunitinib.
- Incyte announces FDA approval of Pemazyre™ (pemigatinib) as first targeted treatment for adults with previously treated, unresectable locally advanced or metastatic Cholangiocarcinoma.
Pemazyre received orphan drug breakthrough therapy and priority review designations based on the significant needs of people living with this devastating cancer.
- As part of Project Orbis, the FDA approved Tukysa (tucatinib) in combination with chemotherapy (trastuzumab and capecitabine) for the treatment of adult patients with advanced forms of HER2-positive
metastatic
breast cancer
that can't be removed with surgery, or has spread to other parts of the body, including the brain, and who have received one or more prior treatments. This is the first new drug the
FDA has approved under International Collaboration.
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MOASC CALENDAR
(Davis, New Dates:
March 11-12, 2021)
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The
Medical Oncology Association of Southern California
(MOASC) is a leading oncology society that advances and protects the ability of cancer patients to obtain, and the ability of the oncology physicians to provide, optimal cancer care.
The material contained in the
California Oncology Weekly
is intended as general information for MOASC members. Because diagnostic, treatment, contracting, coding, and billing decisions should be made on a case-by-case basis, any such information contained in the
California Oncology Weekly
may not apply in any given situation. Members are encouraged to contact their own consultants or advisors to obtain specific advice on matters relating to contracting, coding, and billing. The information contained in
California Oncology Weekly
should not be used as a substitute for such advice.
This publication provides a summary of regulations affecting oncology and its business practices. Reading this newsletter does not substitute for understanding regulations and verifying the validity of every claim. This information is time-sensitive and is subject to change. MOASC accepts no liability for any statements or articles herein.
CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved.
MOASC: P.O. Box 161, Upland, CA 91785 | P (909) 985-9061 | F (909) 804-5006| www.moasc.org
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