SGO Issues June 25, 2015
Annual Meeting Call for Abstracts and Surgical Films opens July 20
Two ICD-10 webinars help members ‘Prepare for the Storm’
Andrea Sloan ‘Right to Try’ law passes in Texas
Globe-athon at United Nations to fight cervical cancer
The Call for Abstracts and Surgical Films for the 2016 SGO Annual Meeting on Women’s Cancer opens Monday, July 20, and closes at 11:59 p.m. CT Tuesday, Sept. 15. The 47th Annual Meeting will take place March 19-22, 2016, at the San Diego Convention Center in San Diego, CA.
With the implementation of the ICD-10 codes set for Oct. 1, SGO Connect Ed will offer two webinars to help members navigate the proverbial rough seas ahead. Coding expert Brad Hart from Reproductive Medicine Administrative Consulting will host “Preparing for the Storm: Understanding the Fundamentals of ICD-10-CM for GYN Oncology,” which is scheduled for July 22 at 7 p.m. ET/6 p.m. CT. Barbara Goff, MD, and Mark Shahin, MD, will moderate. The second webinar, “The Storm is Here: ICD-10-CM Codes and Case Studies for GYN Oncology,” will air Sept. 30 at 7 p.m. ET/6 p.m. CT.
“The participants in this webinar will receive a brief, broad overview of the organization and design of the ICD-10-CM code set,” explained Hart. “They will also receive guidance and advice regarding the use of codes that are specific to the practice of gynecologic oncology. However, most importantly, they will receive practical education on the documentation that will be required to facilitate code selection and to support the medical necessity of the code(s) selected.”
With only three months until ICD-10 implementation, Hart noted that GYN/ONC practices should have already initiated their transition plan, with a focus on the following questions:
- Are the practice’s vendors (EMR, billing, clearinghouse) demonstrating appropriate preparations for ICD-10-CM?
- Have all instances in which ICD-9-CM has been/is being used been identified and have necessary modifications for ICD-10-CM been made?
- Has the practice identified the most commonly used ICD-9-CM codes and identified the corresponding ICD-10-CM codes that will be used?
- Has a concrete formal training plan been established with specific deadlines and benchmarks?
- Has the practice identified solutions to potential revenue slowdowns in the months of October and November?
“While panic is not the appropriate response in anticipation of this transition, it must be taken seriously,” Hart added. “Those that do not take action and assume that it will all ‘work itself out’ on its own are going to face substantial economic and operational hardship.”
On June 12 Texas Gov. Greg Abbott signed into law the “Right to Try” bill, making Texas the 21st state authorizing patients with certain terminal illnesses access to investigational drugs, biological products, and devices that are in clinical trials. The Texas law was the result of a grassroots effort on behalf of Austin lawyer Andrea Sloan, who died on Jan. 1, 2014, from ovarian cancer after waging a public battle for compassionate use of an experimental cancer drug during the last year of her life.
Sloan’s physician Charles Levenback, MD, as well as Robert L. Coleman, MD, both from The University of Texas MD Anderson Cancer Center, had endeavored to procure a PARP inhibitor to treat Sloan because she was a BRCA1 germline mutation carrier and all other treatment options had been exhausted.
“We knew Andrea was BRCA positive for years and had long been talking about the potential option of PARP inhibitors,” said Dr. Levenback. “Unfortunately, we never could get her on to a clinical trial.”
After months of trying, Dr. Coleman was eventually able to put Sloan on a PARP inhibitor by soliciting a pharmaceutical company through the FDA’s Physician Request for a Single Patient Investigational New Drug (IND) for Compassionate or Emergency Use. Although Sloan was starting to gain benefit from the agent, she developed pneumonia and died soon afterwards.
Drs. Levenback and Coleman both see momentum building on a national level for right-to-try legislation.
“My hope is that this law will make it easier for patients to get access to treatments as part of existing compassionate systems,” said Dr. Levenback. “I think the public—as expressed by our elected reps—are frustrated by the barriers to novel therapy for patients without other options.
“For the most part, oncologists support right to try,” Dr. Levenback added. “Some are worried that this type of legislation might give patients false hope. Others worry that unscrupulous providers might find a way to exploit the system.”
“The issue is complex because there are risks to three parties: patient, physician and manufacturer, and [potential] room for abuse,” explained Dr. Coleman. “However, what sparked this bill in Texas was matching a patient with a known biomarker—a germline BRCA carrier—to an agent which had not only phase I (as required by the bill) but also phase II and randomized phase II data of efficacy in BRCA-positive patients.
“What this current law now allows in Texas, under the provisions of the Act, is a clear guide to candidacy for ‘Right to Try,’” said Dr. Coleman. “We’re grateful to move this agenda further but recognize it must be done thoughtfully so as to protect our patients from unnecessary risk but still provide options if reasonable.”
Nearly 120 advocates, physicians and political leaders worldwide convened at the United Nations on June 18 to share knowledge and unite efforts to eradicate cervical cancer. The event was sponsored by Globe-athon to End Women’s Cancer and the Permanent Mission of Grenada in support of the UN’s Sustainable Development Goal No. 3, “To ensure healthy lives and promote well-being for all at all ages.”
Warner Huh, MD, of the University of Alabama at Birmingham presented the success of Australia’s mandatory human papillomavirus (HPV) vaccination program to reduce genital warts, precancers, and HPV-associated cancers. “We know the vaccine works,” he said.
The President of the UN General Assembly, His Excellency San Kutesa, attended the session to commend the initiative and voice support. Groesbeck Parham, MD, Founding Co-director of the African Center of Excellent for Women’s Cancer Control in Zambia, asserted that poverty is the major social determinant of HPV-associated cancers in lower and middle income countries. “The tools exist to eradicate it,” he said. “We just need innovative approaches.”
In response to a question about the role of alternative medicine in cervical cancer treatment, he said the message to traditional healers should be: “We are not here to steal your business. Do what you’re going to do, but also refer women with symptoms to us.”
Larry Maxwell, MD, Globe-athon Executive Director, issued a call to action for advocacy groups to collaborate, use social media, and provide education on risk reduction, early screening and detection, specialty treatments, registries, and the development of guides for policymakers, providers and patients.