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Oncology NEWS International. Vol. 17 No. 6
Consultants Corner 

New codes needed for chronically ill pts

By Marty Neltner

| June 1, 2008
Marty Neltner, a billing & coding expert, has testified numerous times before Senate subcommittees and the AMA on issues concerning the practice of oncology. Mr. Neltner is the founder and president of Neltner Billing and Consulting.

I recently attended a healthcare conference titled “Leadership Summit on Evidence-Based Medicine” in Alexandria, Virginia. As you know, private industry, insurance companies, and the government are trying to develop an evidence-based medicine approach to help check the growth of healthcare expenditures.

The esteemed speakers’ overarching conclusion was that there is currently no independent measurement of evidence-based medicine.

As you can guess, I was one of only a few speakers representing the interests of oncologists. After 3 days, I finally had an opportunity to comment. From the oncology perspective, my solution was simple: Create level six, seven, and eight E&M codes for chronically ill patient care. These codes could be utilized by any physician in any specialty providing chronic care.

For oncology, these new codes would solve the issue surrounding the failed lobbying for oncology treatment planning codes. Treatment planning never happened—even at our urging with a detailed proposal including documentation. As the AMA RUC Committee has stated in denying the new codes: Oncology treatment planning is recognized in the level five services.

These new level six, seven, and eight codes for the management of chronically ill patients would allow oncologists to be compensated for the complexity of their services and would clearly define the outcome measurements needed for applying evidence-based medicine to the treatment of these patients.

 

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