ASCO's Coding Tip of the Month: April 2024
A visit in the hospital setting that is ”split” or “shared” by a physician or non-physician practitioner is subject to split/share billing guidelines. In 2024, CMS finalized their guidelines to split/shared billing to reflect changes enacted in the 2024 AMA CPT manual. In 2024, split/share service levels are determined by:
- Time: The practitioner spending the majority of time with the patient.
- Medical decision-making: The reporting provider performs the substantive portion of the medical decision-making, as defined by guideline instruction.
- Modifier -FS should be appended to the split/shared visit code.
ASCO’s Coverage and Reimbursement resource on Split/Share E/M Services was updated to include more details on split/share billing, including updates, reporting criteria for time and medical decision making, and documentation requirements. Not all payers accept split/share billing. Please refer to individual payer policy for coverage.
Recorded Webinars
2024 Oncology Coding Updates
A review of important 2024 updates from the CPT, ICD-10-CM, and HCPCS code sets that oncology practices need to know.
2024 Medicare Physician Fee Schedule Final Rule Update
Informative session on Medicare’s 2024 Physician Fee Schedule Rule and its impacts on oncology.
Resources
- UPDATED – Care Management and Patient Navigation Services Comparison
- NEW – Coding Snapshot: Advance Care Planning
- NEW – Visit Complexity Add-On Code
- UPDATED – Vaccine Reporting
- UPDATED – Drug Waste Modifiers
- Coding and Reporting Social Determinants of Health
- Hospice Physician Billing
- Split/Shared E/M Services
- Coding Tip of the Month Archive
Practice Administration Guides
Coding Updates
- NEW - April 2024 HCPCS Updates
- January 2024 HCPCS Updates
- 2024 Coding Updates
- 2023 Coding Updates
- 2023 April ICD-10-CM Updates
- 2022 Coding Updates
- 2021 Coding Updates
Evaluation & Management Services Changes
2023 Evaluation & Management Service Changes
- Important Updates to Evaluation and Management Services in 2023
- 2023 Evaluation and Management Changes: Selecting a Code Based on Time
- 2023 Evaluation and Management Changes: Medical Decision-Making Simplified
- 2023 Evaluation and Management Changes: Inpatient, Observation, and Discharge
- 2023 Evaluation and Management Changes: Consultations
- 2023 Evaluation and Management Changes: Guideline Updates, Clarifications, and Corrections
- UPDATED – 2023 Evaluation and Management Changes: Prolonged Services
- 2023 Evaluation and Management Changes: Practice Tips
- ASCO’s Guide to 2023 Evaluation and Management Changes
2021 Office and Outpatient Evaluation & Management Services Changes
- ASCO’s Guide to 2021 Evaluation & Management Changes
- 2021 E/M Changes Updates and Clarifications
- Webinar: Prolonged Evaluation and Management Services
- Changes to Evaluation and Management Codes in 2021
- 2021 Evaluation and Management Changes: Selecting a Code Based on Time
- 2021 Evaluation and Management Changes: New Prolonged Services Code
- Selecting an E/M Code Based on Medical Decision Making in 2021
Coding & Reimbursement Questions?
ASCO members can submit inquiries related to coding, reimbursement, or coverage via email. ASCO staff will respond to your question in a timely manner.