Regina Lohr, Oncology Roundtable
In follow-up to our recent 2013 Oncology Medicare Reimbursement Update, members asked for more specifics on the new Transitional Care Management (TCM) CPT codes included in the 2013 Medicare Physician Fee Schedule.
Requirements, reimbursement vary by patient complexity
The two codes allow providers to bill for one face-to-face visit as well as non-face-to-face services provided to manage patients’ transitions from an inpatient care setting to the community setting (such as the patient’s home or assisted living). Providers billing under these codes must communicate with the patient or caregiver shortly after discharge and meet with the patient within one or two weeks, depending on the complexity of the patient’s case.
What cancer providers need to know about using the new CPT codes
Brian Clement, Oncology Roundtable
A recent article in the Archives of Internal Medicine presents a principled approach to allocating medications during critical drug shortages. The policy was developed and has been used by Duke University Medical Center for more than a year to manage drug shortages.
A medication allocation policy for critical drug shortages
An article in the latest issue of Value-Based Cancer Care describes one hospital's experience managing oral chemotherapy regimens for patients who have been admitted to the hospital. While there has been a great deal of discussion about the challenges of safeguarding patients taking oral medicines at home (see the Roundtable's web conference on the topic here), less attention has been paid to the potential for errors during hospital stays. Yet according to Brian L'Heureux, an oncology pharmacy resident at Suburban Hospital in Bethesda, MD, hospitals should be implementing oral chemotherapy protocols to ensure the safety of patients and staff.
Potential for error stems from numerous factors:
- Admitting physicians tend to continue patients' oral chemotherapy regimens, despite a lack of familiarity with these treatments and the potential for drug-drug interactions
- Nurses working on inpatient units may not be alerted to the fact that a particular drug is oral chemotherapy and therefore requires special handling
- Inpatient nurses typically do not have chemotherpy certification and therefore have to call upon oncology nurses for assistance in handling and administering the drugs.
In order to address these challenges, Dr. L'Heureux has been working to develop new protocols that ensure patient safety. Some of the strategies he has been testing include:
Safety Risks Surrounding Oral Chemo in the Inpatient Setting