1. PRINCIPLES OF BILLING, CODING, COMPLIANCE IN RADIATION ONCOLOGY THE 17TH EDITION BMSi USERS GUIDE

2. PRINCIPLES OF BILLING, CODING AND COMPLIANCE IN RADIATION ONCOLOGY BMSi Day One April 11, 2014 49 SLIDES 041314

3. INTRODUCTION TO THE BMSi SEMINAR SERIES This set of slides will run automatically during the time you are settling in for the morning session These slides are for information purposes only, and are not part of your CME

4. BMSi SEMINARS BMSi is a division of Bogardus Medical Systems, Inc. This seminar is being sponsored and produced in part by Bogardus Medical Systems Inc This seminar is being sponsored and produced in part by Bogardus Medical Systems Inc. THIS IS BMSi SEMINAR # 123 New York city, NY

5. Reformatted Design Based on frequent requests from previous attendees to add more basic information up front for the new individuals, but also to enhance some of the more complicated billing issues for the experienced person, BMSi seminars has reformatted the design of our teaching program.

6. Reformatted Design 1.Experienced attendees do not need some of the basic material. 2.The new attendees are confused by some of the advanced material. 3.Dividing the seminar into 3 levels of teaching solves both problems.

7. Seminar Reformatted This seminar will consist of a new format, still utilizing 12 hours of education, but designed as; 1.A 2 hour introductory session for the beginner, 8:00-10:00 2.A concurrent 2 hour advanced session covering new topics, 8:00-10:00 3.The remaining 10 hours is the standard general session for all attendees.

8. Session Design The introductory session for the beginner, 2 hours on Thursday morning, will be extremely useful to those individuals who have less than one year’s experience with Radiation Oncology. The concurrent advanced session covering new topics, 2 hours on Thursday morning, will be a comprehensive session covering some of the more difficult and specialized procedures that we encounter in compliance and billing. The remainder of the seminar will be the standard general sessions for all attendees,

9. Reformatted Seminar Design The remainder of the program, will cover the bulk of the present seminar subjects in documentation, compliance, and billing. At the request of many previous attendees, we have added an entirely new session on the second day covering the technical aspects of hospital documentation and billing.

10. VIRTUIAL PROGRAM FORMAT Dr. Bogardus will not be here in person, but he will be available and participating using a live video simulcast from the BMSi office in Oklahoma City. This is a live two way communication, and the audience is encouraged to interact with the presenters as we have always done in the past.

11. Carl R. Bogardus, Jr., M.D., FACR, FASTRO CEO of Bogardus Medical Systems, Inc. Dr. Bogardus is Professor, Clinical Director and Vice Chairman of the Department of Radiation Oncology at the University of Oklahoma. He has a career in business and consulting as the founder of Cancer Care Network, Inc. and Bogardus Medical Systems, Inc. Dr. Bogardus’ primary interest over the years has been the development of the Radiation Oncology Coding and Nomenclature System. In 2000, ONCOCHART was developed to meet the compelling need to insure that federally mandated policies and procedures are followed completely; and the productivity and profitability of Radiation Oncologists is enhanced Most radiation oncology billing done today follows the guidelines laid out in his publications.

12. Scott Simmons, President of Eagle Consulting With an Associate Degree from Piedmont Technical College and a Bachelors Degree in Radiation Therapy from the Medical University of South Carolina, Scott began his career in the Jacksonville area as a staff therapist and, later, Chief therapist. After relocating to Georgia in an administrative position, Scott’s facility underwent a Medicare audit, leading to an interest in the business side of radiation oncology and a relationship with Cancer Care Network and Dr. Bogardus. In 2006, Scott formed Eagle Consulting, providing personalized “limited consulting service.”

13. Susan Vannoni, President of Radiation Oncology Consulting, LLC Beginning as a radiographer in the 1970’s, Susan became a registered therapist in South Bend, Indiana, graduated with a B.S in Health Occupations Education from Indiana University, and in the 1980’s became the Program Director of the school of radiation therapy at Memorial Hospital. She received her Masters Degree in Business from Notre Dame. She became Director of Radiation Oncology in 1994 at St. Joseph’s in Phoenix. She entered into management of FSC’s in 2001. During this time, she became associated with Dr. Bogardus, passed the first ROCC exam given, and became a consultant with Cancer Care Network until 2006, when she opened her own consulting service, Radiation Oncology Consulting.

14. Kevin Ewalt President and CEO of RADMAX, LTD. Kevin has over twenty years of experience in the healthcare industry including UCLA Medical Center (Los Angeles, Calif.), Saint John’s Hospital and Health Center (Santa Monica, Calif.) and serving as Director of Operations for East Texas Medical Center (Tyler, Tex.). During his years working in hospitals he has gained expertise in center supervision, project planning, report production, budget planning and medical billing. Kevin is also an accomplished musician and still plays music when time permits. He formed his company, RADMAX in 2004. Kevin’s ability to think creatively as well as analytically makes him a unique leader and instrumental in RADMAX’s success.

15. BMSi Seminars Basic Principles of Documentation, Billing, Coding, and Compliance in Radiation Oncology Carl R. Bogardus, Jr., M.D., FACR, FASTRO Professor, Dept. Radiation Oncology Director of Clinical Services University of Oklahoma HSC Oklahoma City, OK Modified For 04-10-14 49 Slides

16. The front cover of your book has the unique serial number of your copy of the book 17.003.4454 Copy number of your book Printing of this version of the book Edition of this manual

17. Radiation Oncology Seminar Manual Print full name Billing Site/Center Address City, State, Zip Code DID YOU REMEMBER TO FILL IN YOUR OWNERSHIP INFORMATION? THIS IS YOUR BOOK

18. Sponsors of the Documentation, Billing, Coding, and Compliance seminar series This seminar series is very expensive to produce and maintain for many reasons. All of our costs are more than your combined tuitions for the limited number of professionals attending this highly specialized seminar series. We are able to hold the tuition stable and continue to provide these seminars through the generous support of our sponsors, who help make all of this possible All of our costs are more than your combined tuitions for the limited number of professionals attending this highly specialized seminar series. We are able to hold the tuition stable and continue to provide these seminars through the generous support of our sponsors, who help make all of this possible. Please acknowledge their contributions to your educational experience. 1-A

19. Jeff Carlin of BMSi is available to meet with you and demonstrate the features of ONCOCHART If you are interested in further information on ONCOCHART for your practice, a WEB demonstration can be arranged Flyers, a summary booklet, and demonstration CD, are available in the lobby ONCOCHART WAS THE FIRST ELECTRONIC HEALTH RECORD PROGRAM IN RADIATION ONCOLOGY TO BE FULLY CERTIFIED

20. Now certified for meaningful use TWO. BMSi was number 9 in the country to achieve this milestone.

21. 1-C Scott Simmons is the owner of Eagle Consulting, and is a regular lecturer at the BMSi seminars Scott is available to help you and your practice with the many complex issues of today's world of billing and compliance as a consultant, onsite or in a limited online consulting arrangement

22. 1-D Susan owns her business of Radiation Oncology Consulting. She has many years of experience in the management of centers, and the knowledge this brings to her consulting business. Susan is available to do on site consulting and also limited on line consulting work Susan Vannoni is a regular lecturer at the BMSi seminars.

23. BMSi Publishing Production Design Carl R Bogardus, Jr MD Book Editor in Chief Carol Gravlee Director of Printing Colleen Mallory Manager of Compliance Lynn Miller, BsRn, Onc Seminar coordinator Carol Gravlee

24. American Medical Association (AMA) CPT, ICD-9 American College of Radiology (ACR) American Joint Committee on Cancer Oncochart (BMSi) Section 1 Introduction, Credits & Disclaimers Covered by pages 14-18

25. NOTICE OF PERMISSION All patient related material, to include photographs of the patient, the patient’s tumor site, and all associated electronic representations of patient material is being used as a scientific presentation with the complete understanding of the patient and with their full written consent. A signed, dated, and witnessed consent form is on file in the department of radiation oncology. NIB

26. BMSi SEMINARS Commercial Discloser BMSi Seminars is a production of Bogardus Medical Systems, Inc., BMSi is owned in part by C. R. Bogardus, JR, M.D. BMSi is responsible for the development of the Oncochart Program, which is used extensively throughout this Seminar for the sole purpose of illustration of proper documentation 1-13

27. COPYRIGHT LEGAL OPINION This use of a limited number of CPT codes constitutes “FAIR USE” as defined under Chapter 1, Sect 107 US copyright law.

28. This Seminar Manual is intended to be a supplement rather than a replacement for the American Medical Association’s Physician’s Current Procedural Terminology (CPT).

29. It should be noted that the information contained in this manual does not constitute law or HCFA policy.

30. WARNING DISCLAIMER Reimbursement policies vary widely between insurers, and even the same insurer in different parts of the country Reimbursement policies are subject to change without notice. The information in these books may be current at the time of the seminar, but can be out of date by the time of your use. If in doubt check with your insurer.If in doubt check with your insurer.

31. Meeting Your Educational Needs Radiation oncology billing is the most complex of all medical billing scenarios. To be able to correctly bill radiation oncology procedures, you must first have a basic understanding of the science of radiation oncology. The science leads to procedures. All procedures must be medically compliant. Compliant procedures may be billed..This book and the accompanying course work form only a basic primer in the science of radiation oncology, but it is an advanced course covering the requirements for documentation. Section 1,Page13

32. THE GOAL OF THIS SEMINAR HAS BEEN : TO TEACH:TO TEACH: –Documentation –Compliance –Charge capture –Billing 1-13

33. CONTINUING EDUCATION CREDITS Category II Credits12 CEU AMA Category II Credits 12 CEU ASRT Credits 12.5 CEU AAPC Credits 12 CEU ROCC Exam Credits YOU MUST COMPLETE AND SIGN THE EVALUATION FORM TO RECEIVE YOUR EDUCATIONAL CREDITS PARTICIPANTS ARE TO CLAIM ONLY THOSE CREDITS THAT APPLY TO THEIR SPECIALTY, AND COMMENSURATE WITH THE EXTENT OF THEIR PARTICIPATION IN THIS ACTIVITY. YOU MUST COMPLETE AND SIGN THE EVALUATION FORM TO RECEIVE YOUR EDUCATIONAL CREDITS

34. PROGRAM MODIFICATIONS At the request of previous audiences, and in response to your critique forms, changes are often made to the program.At the request of previous audiences, and in response to your critique forms, changes are often made to the program. One of these to save your valuable time, is that we are covering the basic introductions as you get settled in the room. The required disclaimers are in the book and do not need to be re-stated.

35. Follow the program guide. The lecture series will not sequentially follow the book chapters. This is necessary to allow the correct amount of time for each section to be fully presented. PROGRAM GUIDE NOTICE!! NOTICE!!

36. The program guide allows you to follow the sequence of the lectures, the person doing the presentation, and the section of the User’s Guide where the lecture material is located.

37. SLIDES AND PAGE NUMBERS MAY NOT MATCH EXACTLY This lecture is constantly changing and it is difficult to keep all the slides correlated with the page numbers. In any event they may be off only a page or two, let us know at the time if you cant find a section

38. There are multiple reasons why the number on the slide may not match the page in the book. The primary reason is related to multiple modifications of the slides and book chapter to meet new rules and current thinking. An equally important reason is related to paraphrasing and shortening the data on the slide to the point where it may be difficult to recognize where it came from in the book. And some slides are just not in the book, NIB.

39. NAVIGATION AID TO THE FORMAT OF YOUR BMSi SEMINAR MANUAL Each section starts with new page numbers. Be sure you are in the correct section of the bookEach section starts with new page numbers. Be sure you are in the correct section of the book Most of the slides have reference page numbers on the slide. 32 Page 32 Section 5 V 17.001

40. SLIDES NOT IN BOOK SOME OF THE SLIDES IN THIS LECTURE ARE NOT IN THE BOOK THEY HAVE BEEN ADDED TO MAKE THE LECTURE MATERIAL MORE UNDERSTANDABLE, AND FOR CLARIFICATION OF DOCUMENTATION AND ILLUSTRATIONS OF MEDICAL NECESSITY NIB

41. VERSION NUMBER Some sections of this book are unchanged from previous printings and may have different version numbers listed on the bottom of each page of the section. This is not an error, sections that have been reworked will have a new number, while older sections may retain the original number.

42. This seminar will be followed in two weeks on April 24, 2014 with a live two way web based seminar follow up, exclusively for attendees of this seminar and their office staff, see Carol for details of participation WHAT DID WE LEARN? Please discuss this seminar with your office staff and come up with questions or suggestions about what you learned, or what you want to know more about. Send in your questions and I will discuss them at the WHAT DID WE LEARN session.

43. Today's Morning Schedule 8:00-10:00 Basic introduction to radiation oncology 8:00-9:00 History, terms, equipment……… section 14 9:00-10:00 CPT, CCI, Modifiers…………….. section 2 8: 00-10:00 Advanced techniques radiation oncology 8: 00-9:00 Brachy therapy………………….. section 12 9:00-10:00 SRS, SBRT, proton ……………..section 10 10:00-10:15 Break 10:15-11:15 E/M procedures…………………. section 5 11:15-12:00 EHR, meaningful use …………...section 3 12:00-1:00 Lunch, ONCOCHART demonstration

44. Today's Afternoon Schedule 1:00-1:30 Updates………………………….. Not in Book 1:30-2:00 Clinical treatment planning……… section 6 2:00-3:00 Simulation…………………………... section 7 3:00-3:15 Break 3:15-4:00 Dosimetry…………………………… section 8 4:00-5:00 Treatment delivery………………… section 9

45. PLEASE TURN OFF, OR SET ON SILENT.

46. SEMINARS IN 2014 February 20-21Orlando March 20-21Anaheim April 10-11New York City May 16-17San Antonio June 12-13 Nashville July 24-25 Colorado Springs August 14-15 Chicago October 2-3 New Orleans November 7-6 Miami December 3-4-5 Las Vegas

47. PRINCIPLES OF BILLING, CODING AND COMPLIANCE IN RADIATION ONCOLOGY BMSi END AUTO RUN Day One 2014

48. THE SEMINAR WILL START IN A FEW MOMENTS, THANK YOU