SGO Issues Dec. 5, 2019
Coding Corner: Use of Modifiers 24 and 25 to ensure reimbursement | Cheryl C. Saenz, MD
Upcoming patient webinar: Shared Decision Making in Ovarian Cancer
SGO Wellness: Self-care tips from Westchester Medical Center
SGO 50th Anniversary: Joyce Barlin, MD
December 2019 Gynecologic Oncology highlights
Late-breaking abstract submissions now open for Annual Meeting
New! FWC 2020 Calendars
Dr. Rauh-Hain wins Practice Survey drawing
How to use Modifiers 24 and 25 for unrelated services by the same physician or other qualified professional during the postoperative period.
As the only surgeons who are formally trained to prescribe chemotherapy, gynecologic oncologists will often find themselves providing patients with services related to chemotherapy counseling and symptom management within the 90-day global period. If Modifier 24 is not attached with the evaluation and management (E&M) service, the gynecologic oncologist will likely not be reimbursed.
Attaching Modifier 24 to denote an unrelated E&M service must be supported by a diagnosis code that clearly supports the reason why it is not simply postop care (that is, a diagnosis code that differs from the code used for surgery). Using Modifier 24 alone will not support reimbursement, but Modifier 24 plus an unrelated diagnosis code will.
For example, if a patient is taken to the OR for a pelvic mass (ICD 10 R19.00), but the final pathology reveals ovarian cancer (ICD 10 C56.9), the ovarian cancer diagnosis should be used for the subsequent postoperative visit where chemotherapy is discussed. However, if the patient is taken to the OR for endometrial cancer (ICD 10 C54.1) and postoperatively she is seen for a discussion of chemotherapy, the ICD 10 codes used should be both C54.1 and Z71.89 (other specified counseling).
The code used to support Modifier 24 (Z71.89) should be placed as the first diagnosis and the cancer diagnosis codes may be listed next. For E&M visits prior to chemotherapy the most accurate code is Z01.818 (encounter for preprocedural examination, including prior to chemotherapy). On days where chemotherapy is administered, the Z51.11 (encounter for antineoplastic chemotherapy) can be used as the first diagnosis if you are also administering the chemotherapy.
Modifier 25 is used to denote unrelated procedures during the global period. This includes chemotherapy administration as well as other procedures such as port placement.
Cheryl C. Saenz, MD, is a Gynecologic Oncologist at the Moores UCSD Cancer Center in San Diego, CA.
Encourage your patients to join the Foundation for Women’s Cancer (FWC) on Wednesday, Dec. 18, at 7:00 p.m. CT for a free one-hour webinar focusing on the use of a shared decision-making approach between patients and clinicians when seeking treatment for ovarian cancer. With a variety of treatment options available, this webinar will help your patients learn how to become their own advocate to obtain the most effective method possible in the treatment of their disease. Speakers include Shirley Dau, ovarian cancer patient and advocate, and Nita Lee, MD, SGO member and gynecologic oncologist at the University of Chicago Medicine. Share this webinar on Facebook.
SGO wishes everyone Happy Holidays and encourages all of our members to be mindful of maintaining wellness throughout the year. Our thanks to Gizelka David-West, MD, and the Division of Gynecologic Oncology and Robotic Surgery at Westchester Medical Center in Valhalla, NY, for their demonstration of how to de-stress during this hectic time of year. Excellent patient care starts with your own self-care.
For 50 years, SGO has fostered personal and professional development. With an emphasis on inclusivity, Joyce Barlin, MD, discusses the value of diversifying SGO’s membership and what it means for the organization’s future.
Review: Reproductive and Hormonal Considerations in Women at Increased Risk for Hereditary Gynecologic Cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review Lee-may Chen, Stephanie V. Blank, Elizabeth Burton, Karen Glass, Emily Penick, Terri Woodard
Editor’s Choice: A phase II randomized, double-blind trial of a polyvalent Vaccine-KLH conjugate (NSC 748933 IND# 14384) + OPT-821 versus OPT-821 in patients with epithelial ovarian, fallopian tube, or peritoneal cancer who are in second or third complete remission: An NRG Oncology/GOG study Roisin E. O’Cearbhaill, Wei Deng, Lee-may Chen, Joseph A. Lucci III, Kian Behbakht, Nick M. Spirtos, Carolyn Y. Muller, Benedict B. Benigno, Matthew A. Powell, Emily Berry, Krishnansu S. Tewari, Parviz Hanjani, Heather A. Lankes, Carol Aghajanian, Paul J. Sabbatini
Ovarian Cancer: Secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer before olaparib maintenance: Still getting any benefit? A case-control study C. Marchetti, A. Rosati, G. Scaletta, A. Pietragalla, M. Arcieri, R. Ergasti, E. Palluzzi, G. Scambia, A. Fagotti
Now through Tuesday, Jan. 7, 2020, SGO will accept abstract submissions for consideration as a late-breaking abstract at the SGO 2020 Annual Meeting on Women’s Cancer® March 28-31 in Toronto, Canada. The late-breaking abstract session will focus on scientific data that has become available since the original abstract submission deadline of Sept. 22, 2019. Submissions can include preliminary findings if data analysis is still ongoing; however, trials or experiments for which data collection is not yet complete are discouraged. Abstracts should reflect scientific methods and statistical power suitable for a plenary presentation and should not be previously published or presented. Abstracts already submitted in response to the original Call for Abstracts for the SGO 2020 Annual Meeting are not eligible for resubmission. Contact email@example.com with any questions.
The new Foundation for Women’s Cancer (FWC) 2020 Calendar is available as a PDF file to download and print from the FWC website. As a token of appreciation for your commitment to the FWC mission, all SGO members were sent a printed copy. If you do not receive one or if you would like to order additional copies for your office or patients, please email FWCinfo@sgo.org (printed calendars are available while supplies last).
SGO congratulates Jose Alejandro Rauh-Hain, MD, from The University of Texas MD Anderson Cancer Center in Houston, TX, as the winner of a drawing for a complimentary registration to the SGO 2020 Annual Meeting on Women’s Cancer in Toronto, Canada, March 28-31 for completing the SGO Practice Survey earlier this year. The five-year benchmarking survey garnered a 48 percent response rate by full gynecologic oncologists, international and Advanced Practice Provider members. Highlights of the data findings will be presented during the 2020 Annual Meetings’ Member Forum. The full report (print and PDF versions) will be available in April 2020.