This Weekly's Hot Topics

MOASC is pleased to introduce the oncologists from the USC Keck School of Medicine/Norris Comprehensive Cancer Center to the association. We look forward to lively clinical dialogue and exchanges with our new colleagues. Welcome USC! 

MOASC Programs - Save the Dates - All Times are Pacific

TOMORROW! October 27, in recognition of Breast Cancer Awareness Month, MOASC presents a virtual conference on “Treatment of Breast Cancer,” 5:30pm to 7:00pm. Moderated by Dr. Reema Batra, Cancer Center Oncology Medical Group with panelists Dr. Kelly Dewitt, Sharp Healthcare and Dr. Meera Ravindranathan, Sharp Healthcare.

October 29-30, the University of California San Diego invites you to their inaugural Delivering Discoveries: Updates in Oncology CME conference. This 1.5 day event will address all aspects of cancer from basic science research, advances in clinical care, to community-based approaches that optimize prevention and interception. 

November 3, in recognition of Lung Cancer Awareness Month, MOASC presents a virtual conference on “Recent Advances in Lung Cancer,” 5:30pm to 7:00pm-PDT. 

To learn more about what you can do to help your valuable human resource, and more, MOASC invites you to attend the virtual MOASC Annual Management Series for Oncology Administration & Accounts Receivable Management. The Administration Track 1 on November 4, 11:45am – 3:15pm topics are: Prevent Burnout & Employee Fatigue; Time Management: Find an extra hour every day; Create a More Productive Practice with Process Automation; Improve Patient Collections Experience, and Match Patients to Clinical Trials.

Followed with the Oncology Accounts Receivable-Track 2, on November 10, 11:45am to 3:15pm, with topics including: 2022 Billing Updates; Overview of Medicare Regulations; Billing tips for Advanced Practice Providers, and How to Increase Revenue.

How did California go from the epicenter of the US pandemic to the lowest statewide transmission rate? The state has some of the strictest vaccine mandates and masking policies.

With the lowest COVID-19 infection rate among all states as of Friday, California, which has some of the strictest mask and vaccination mandates in the country, has managed to flip the script as the former U.S. epicenter of the pandemic.

Gov. Gavin Newsom and higher education leaders on Monday visited the future site of UC Merced’s medical education program, which would serve a building block for the San Joaquin Valley’s first public medical school. Proponents of the highly anticipated project said the program would lead to more doctors serving in the Central Valley, as well as a diverse physician workforce that reflects the region’s Latino community. Newsom spoke at the site of a planned $210 million medical building that would anchor a program for students studying health sciences, public health and behavioral health sciences. It’s designed to feed into a graduate medical school at the Fresno campus of the University of California.

Beginning January 1, 2022, all Part D sponsors are required to have a Drug Management Program, and to include beneficiaries with a history of opioid-related overdose in their DMP pursuant to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. CMS codified these requirements and other policy changes in the 2022 Parts C & D.

New/Modifications to the POS Codes for Telehealth - R 12427 provides updates to the current Place of Service (POS) code set by revising the description of existing POS code 02 and adding new POS code 10. Make sure your billing staff knows of the updates.

Claim Status Category and Claim Status Codes Update - The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires all covered entities to use only Claim Status Category Codes and Claim Status Codes approved by the National Code Maintenance Committee in the ASC X12 276/277 Health Care Claim Status Request and Response transaction standards adopted under HIPAA for electronically submitting health care claims status requests and responses. These codes explain the status of submitted claim(s). HIPAA doesn’t allow use of proprietary codes in ASC X12 276/277 transactions to report claim status. 

Quarterly Medicare Updates - A/B - After Hours Webinar - October 14, 2021. This event includes: CMS and Noridian Updates, October 2021 Quarterly Provider Updates, Change Requests (CR), Recurring Updates, Special Editions (SE), and Resources.

October 26 - External Breast Prosthesis (EBP), Mammography and Physician Orders Webinar. This webinar is intended for Medicare Part B providers and DME suppliers and will include: • Mammography Screening/Diagnostic • Coverage Criteria and Coding • Orders and Documentation • Reminders and Resources. 

October 27 - The Noridian Provider Outreach and Education (POE) staff is hosting the Screening Services: Mammography, Pap Test and Pelvic Exam webinar. This webinar is intended for Medicare Part B Providers and will include: • Screening Mammography • Screening Pap Test • Screening Pelvic Examination • Screening for Cervical Cancer with Human Papilloma Virus (HPV) Test • Resources.

October 27 - Comprehensive Error Rate Testing (CERT) Clinic Webinar. The CERT Overview will address, Part A Missing Documentation - SNF, Labs/Diagnostic Tests, TAVR, ICD, OP Therapy, Part B Missing Documentation - Policy-Based Denials, DME - NPI Billing Errors, Refill Request Errors, Error Prevention, and Website Tour.

Effective October 20, 2021, FDA amended the emergency use authorizations for the Moderna and Jansen (Johnson & Johnson) COVID-19 vaccines to allow for use of a single booster dose for certain populations.

CR 12177 tells you that, effective for claims with dates of service on or after August 7, 2019, CMS covers autologous treatment for cancer with T-cells expressing at least 1 Chimeric Antigen Receptor (CAR) when administered at healthcare facilities: Enrolled in the FDA Risk Evaluation and Mitigation Strategies (REMS) and meets specified CMS/FDA criteria. 

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2022. According to the Medicare Claims Processing Manual, Chapter 16, Section 120.2 , CMS updates the laboratory edit module as necessary to reflect coding updates and substantive changes to the NCDs. Make sure that your billing staff knows of these changes.

In honor of breast cancer awareness month, ANCO will be having Dr. Pamela Munster participate in the October 21st ANCO Connections. Dr. Munster recently authored Twisting Fate, about her experience as an oncologist and a cancer patient. The first 20 registered health care providers will receive a copy of her book. 

ANCO's 2021 Professional Education Meeting is taking place virtually on October 27th.  

ANCO's Hematologic Malignancies Updates (part III of III), will be November 6, 2021- Hyatt Regency San Francisco Embarcadero. The faculty will present the latest research on treatment modalities for hematologic malignancies—leukemias, lymphomas, and myeloma—along with case studies for these diagnoses. Registration deadline is Thursday, November 4th.

Four seats on the ANCO Board of Directors are up for election in 2021. ANCO seeks nominations for candidates to stand for election to these seats. This year's election will be conducted via election runner online in December. Candidates with the top four vote totals will serve for three years (i.e., from 2022-2024, inclusive). You may nominate an ANCO member (including yourself) to stand for election to the Board via e-mail to director@anco.org no later than November 15.

Reconnect with old friends and make new ones at the 63rd ASH Annual Meeting and Exposition on December 11-14 in Atlanta and virtually. Read more about the various opportunities to connect with participants at the "Welcome Back" Reception, ASH-a-Palooza and Trainee Welcome Reception, Hallway Conversations and ASH Collaboration Rooms.

CMA recently joined the American Medical Association and 28 other medical and specialty societies to express strong concerns over unfair business practices with respect to electronic payments in health care. CMA has for many years urged CMS to clarify and enforce the right of physicians to receive electronic payments via the Automated Clearing House electronic funds transfer (EFT) standard without being forced to pay percentage-based fees for “value-added” services.

COA NEEDS YOUR HELP regarding unfairness of DIR fees and PBM delays. COA has been working with Congressional representatives and senators to fix these issues, but still need YOUR help! Two bills are making their way through Congress that would: force PBMs to speed up their authorization process for oral cancer medications and eliminate retroactive DIR fees. These are hugely important bills to community oncology practices and patients alike – but Congress wants to hear your support for these bills! The more co-sponsors community oncology can get aligned in Congress with these bills the more likely they will come to a vote in the Senate or House of Representatives so you reaching out to your members is so, so important! The COA team has created an easy-to-use support kit to help you contact your legislators. It neatly summarizes both bills, provides talking points for conversations, and includes sample language for reaching out over social media or email. Please take this kit and run with it so we can notch some wins for community oncology and patients with cancer!

Please support the Friends of Community Oncology PAC (FCO PAC). FCO needs your support! Each year you can contribute up to $5,000. Even if it is an additional $50 or $500, every dollar counts. The election cycle never really ends in Washington, but it is absolutely going to heat up in the coming months.  In 2022, all 435 seats in the House and 34 seats in the Senate will be up for election.  Who comes into power will have tremendous influence over the policies that impact your patients and practices!

Eli Lilly and Company announced updated data from the positive Phase 3 monarchE trial evaluating the investigational use of Verzenio^® (abemaciclib) in combination with standard adjuvant endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), node-positive, high risk early breast cancer (EBC).

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.