Radiation Oncology CAC etwork &

New York State CAC Report

from Louis Potters, MD

    
     1. A draft intravascular brachytherapy policy was forwarded to us to
     review. Dr. Rainford, the CMD for Empire is in fact directing a
     similar draft IVB policy nationally. As such, our comments to him
     directly will effect the draft policies that will be forthcoming
     nationally. Fortunately, the draft policy is written with favorable
     language and after receiving comments from other Joint Economics
     Committee Members, a response letter was submitted back to Dr.
     Rainford for minor changes.
    
     2. A draft policy on Grenz ray therapy was put forth. The intention is
     for dermatologists to use such therapy in their offices. ACR/ASTRO has
     decided not to comment in writing on this policy as is is somewhat
     benign. Nonetheless, I made direct comment at last weeks CAC meeting
     that the ACR/ASTRO opposes the ICD-9 codes as they represent benign
     conditions that we do not feel should be treated with radiation.
    
     3. CMS has leaked a potential rule that will change the structure and
     nature of the CAC structure. Both the ACR and ASTRO signed onto a
     letter drafted by the AMA opposing such a rule change. Both societies
     had drafted and sent individual letters with a similar intent. The
     rumored rule change will allow each Medicare carrier to set rules for
     the CAC and may even disallow the CMD from participating in this
     process. The CAC process is our (physicians) only direct way of
     commenting on draft policies and we fell it is important that such a
     system remain intact until or at least the specialty societies are
     provided an opportunity to provide input on its change.
    
     4. Dr. Potters presented a billing lecture to upstate radiation
     oncologists in Syracuse in September.
    
     5. The ACR/ASTRO JEC has completed the users guide for radiation
     oncology coding which is now available on each web site. This book
     contains information on the structure and operations of CMS in
     addition to specific coding issues and reflects a significant amount
     of work and time by the committee.