09/11/2024

ASCO's Coding Tip of the Month

September 2024

Do you know how codes used to report services are created? What about how reimbursement rates are determined?

CPT stands for Current Procedural Terminology, and each code goes through the AMA CPT Editorial Panel for review before being added to the CPT code manual. 

Reimbursement value recommendations are developed through a process administered by the AMA’s RVS Update Committee (RUC) and, if approved, are sent to Center for Medicare and Medicaid Services (CMS) for consideration.  CMS details their decision on whether to apply those recommendations or alternate considerations each year in their Proposed and Final Rules for the Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS).

ASCO is represented in both the CPT and RUC by volunteer advisors, who dedicate a significant amount of time engaging in these important processes.

CPT Editorial Panel

• Dr. Joseph Merchant (Primary)
• Dr. Rahul Seth (Alternate)

RVS Update Committee

• Dr. Elizabeth Blanchard (Primary)
• Dr. Arturo Loaiza-Bonilla (Alternate)

ASCO provides a summary of oncology related coding updates each year in the fall. Learn more about how the CPT and RUC’s work impact the Medicare Physician Fee Schedule in the ASCO Webinar “2025 Physician Fee Schedule Proposed Rule and the Impact on Oncology”.