evicore radiation oncology guidelines 2020 High end imaging - Cardiac imaging and elective heart catheterization; High end imaging - Radiation therapy Send predetermination requests to the address or fax on the form. 2. Guidelines with substantive changes: ARLINGTON, Va. com. (SRS) and stereotactic body radiation therapy (SBRT). RBS also announced the development of their new, quality-driven radiation oncology network, VidaCore. Mar 29, 2021. Radiation therapy - Mayo Clinic. The Guidelines and Pathways are designed to evaluate and direct the appropriate utilization of certain health care services. View eviCore updates and other upcoming prior authorization enhancements Clinical guidelines, treatment checklists and other tools specific to both ordering providers and radiation oncology facilities can be accessed below for selected cancer sites. Details: eviCore eviCore will provide Utilization Management programs for Radiation Therapy and Radiology/Cardiology for Horizon NJ Health and Horizon NJ Total Care (HMO D-SNP) members effective January 1, 2020. " A report from the American Society for Therapeutic and Radiation Oncology (ASTRO) (2012) concludes that there is insufficient evidence to support the use of proton beam therapy for head and neck cancers, and conclude that "current data do not provide sufficient evidence to recommend PBT in head and neck cancer… Effective for dates of service on and after February 9, 2020, the following updates by section will apply to the AIM Specialty Health ® Clinical Appropriateness Guidelines for Radiation Oncology. Locoregional control with radiation therapy alone ranged from 40 to 50% vs. Effective 09/21/2020. Preauthorization of outpatient radiation oncology services and outpatient physical and occupational therapy — eviCore healthcare® . AIM Clinical Appropriateness Guidelines for Radiology. View eviCore updates and other upcoming prior authorization enhancements New code 2020. Aetna will require providers to request a prior authorization for non-emergent outpatient diagnostic left and right heart catheterization services. By working together, we ensure patients receive the most appropriate treatment the first time. AmeriHealth has delegated the responsibility for utilization management activities for certain radiation therapy services to eviCore for commercial AmeriHealth members. In response to the Oct. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of 33 eviCore healthcare reviews. Although AIM has a process for updating its Guidelines and Pathways on a regular basis, due to the rapidly evolving nature of medicine, these Guidelines and Pathways may not reflect the most current evidence on a particular service or treatment. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Billing and Coding Guidelines for Radiation Oncology Including Intensity Modulated Radiation Therapy (IMRT) LCD Determination ID Number L34652 Guidelines Reasons for Denial Services performed for diagnoses not listed as covered in this policy or for excessive frequency will be denied as not medically necessary. Leaders of the American Society for Radiation Oncology (ASTRO) urge eviCore, a radiation oncology benefits management company, to halt and make meaningful changes to a new policy for radiation • Medical Oncology Drug Prior Authorization Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program (Effective 11/1/20, P66-20) • Page Radiation Oncology Clinical Guideline Updates for Fully Insured Commercial and Decipher Prostate is the first and only genomic test recognized by eviCore for the management of prostate cancer patients after surgery . A 12-month AUC consultation educational and operations testing period officially began Jan. Guideline updates will become effective March 2, 2020: Please review all guidelines when submitting a prior authorization request. Clinical guidelines, treatment checklists and other tools specific to both ordering providers and radiation oncology facilities can be accessed below for selected cancer sites. Use the eviCore Provider Portal to submit prior authorization requests. 13% off Offer Details: For Blue Cross PPO (commercial) members Providers must obtain authorization from eviCore ® healthcare for: Outpatient radiation therapy (oncology) Outpatient interventional pain management – For dates of service from Jan. CT Guidance for Placement of Radiation Therapy Fields 77014 Unlisted CT procedure (for radiation planning or surgical software) 76497 Nuclear Medicine CPT® PET Imaging; limited area (this code not used in pediatrics) 78811 PET Imaging: skull base to mid -thigh (this code not used in pediatrics) 78812 Radiation Therapy: Medical Oncology: Sleep Management Horizon BCBSNJ, in collaboration with eviCore healthcare, has implemented a Pre-service Medical Necessity Determination (MND) program. com therapy compared to radiation therapy alone (Bartelink et al, 1997; Northover et al, 2010). This program is to help ensure that the radiation therapy services provided to our members are consistent with nationally recognized clinical standards. 2020 of the NCCN Guidelines for Non-Small Cell Lung Cancer from Version 1. Retrieved January 29, 2021 from the National Comprehensive Cancer Network. evicore. CaesarRO. 23, 2020 Replaces: N/A RELATED MEDICAL POLICIES/GUIDELINES: 10. View code list for high end imaging prior authorizations View code list for Radiation Therapy eviCore FAQs. 01. . A free inside look at company reviews and salaries posted anonymously by employees. Draft guidelines are posted 90 days prior to implementation. 1, 2020) NASHVILLE, Tenn. com/auth_lookup. 4, 5 Reimbursement for SRS is high; therefore, payers are critical of the appropriate indications 01/01/2020, there will be changes to the authorization requirements for services you may order or render for our members. eviCore healthcare’s Clinical Guidelines and request forms are available at: www. If you would like to view all eviCore core guidelines, please type in "eviCore healthcare" as your health plan. effective November 2, 2019: Please review all guidelines when submitting a prior authorization request. Oncology Medication Policy. Reactions: 1 user Reply. Coding Guidelines . eviCore guidelines are currently available on their website at eviCore. eviCore. This is a rapid process and can be turned around quickly. 33 eviCore healthcare reviews. NIA incorporated input from Revenue Cycle Inc. To speak to a representative, call eviCore at 1-866-496-6200, weekdays, 7 a. eviCore simplifies authorization process for radiation oncology, starting July 1, 2020. Updated: June 3, 2020. to 7 p. Radiation oncologists today expressed serious concerns about a new private insurance coverage policy that could undermine patient-centered care for two of the most common cancers in the United States. ASTRO has confirmed that eviCore will update its Radiation Oncology Guidelines to permit coverage for hippocampal avoidance (HA) whole-brain Intensity Modulated Radiation Therapy (IMRT). According to Aenta- starting in December 1, 2020. 00. Pediatric Oncology Imaging Guidelines, except where directed otherwise by a specific guideline section 15 to 39 years old at initial diagnosis (defined as Adolescent and Young Adult (AYA) oncology individuals) When unique guidelines for a specific cancer type exist only in either Oncology or Pediatric Oncology, AYA individuals should There may be instances in which your health plan policies take precedence over the eviCore healthcare clinical guidelines. To view this policy, visit our Medical and Claim Payment Policy Portal. 31, 2020. 1, 2019), Medicare Plus Blue members (for dates of service on or after Jan. 3,316 likes · 11 talking about this. (2019, May). 11. eviCore will use the updated Radiation Therapy Clinical Guidelines to determine the medical necessity for these services. Tired? Insufficient sleep is associated with a number of chronic diseases and conditions. Sleep Studies and Sleep Durable Medical Equipment (DME) (No prior authorization required for the resupply of Sleep DME supplies effective 8/1/2018 Requires contacting eviCore for Prior Authorization at evicore. LCD Title . 01. You may also go directly to eviCore’s self-service web portal at www. com in the near future. or D. For radiation therapy services only Go to eviCore. eviCore healthcare, Bluffton, South Carolina. Radiation Oncology for all Outpatient and • eviCore Evidence-based Guidelines • MCG Care Guidelines(MCG) Radiation Therapy Coverage, Coding, and Reimbursement for New Technologies Presented by Susan Granucci, Healthcare Reimbursement Specialist Topics 1. com Radiation Therapy Program Questions and Answers . 1200/JCO. Effective 01/11/2021. Your doctor will recommend radiation therapy if the doctor thinks that the benefit you may have from this treatment is greater than the risks. Horizon BCBSNJ is partnered with eviCore healthcare to manage Advanced Access to these Guidelines and Pathways is being provided for informational purposes only. Sites must meet 4 of the 5 measures to be eligible for the 2nd year of the Gold Card Incentive Program. (2020, November). , a radiation oncology medical billing company NCCN guidelines on head and neck cancer (NCCN, 2020) state that "[p]roton therapy may be considered when normal tissue constraints cannot be met by photon-based therapy. Positron emission tomography (PET) also known as positron emission transverse tomography (PETT), or positron emission coincident imaging (PECI), is a non-invasive diagnostic imaging procedure that assesses the level of metabolic activity and perfusion in various organ systems of the human San Diego – February 18, 2020. Removed Xofigo from bone metastases guideline to be a standalone guideline. 1, 2020 Last Revised: Jan. Sleep 7. Effective October 1, 2020, eviCore healthcare (eviCore), a specialty benefit management company, will use updated Radiation Therapy Clinical Guidelines for AmeriHealth members. eviCore Healthcare (eviCore) provides outpatient imaging management services for Horizon NJ Health. MeridianComplete (Medicare-Medicaid Plan). The Criteria for Year 5 (measurement period: 1/1/2021-09/30/2021; effective 3/1/202 2-2/28/2023) is listed below. bluecrossmn. Our state-specific browser-based samples and simple guidelines eliminate human-prone mistakes. eviCore stated that staff are authorized to approve requests for HA whole-brain IMRT for appropriate patients while the Guidelines are being eviCore manages these services for BCN Advantage members: • Physical, occupational and speech therapy by therapists for non- autism diagnoses — eff. Radiation Therapy for Skin Cancer – Basal cell and Squamous cell Cancers This is a new guideline that was part of the Radiation Therapy for Skin Cancer guideline. For Outpatient Radiation Therapy, Molecular and Genomic Testing Pre-authorizations refer to the eviCore tab. Guidelines with substantive changes: • Breast Cancer • Brain Metastases • Image-Guided Radiation Therapy (IGRT) As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, we will be implementing changes to evicore. 1, 2015 • Select interventional pain management procedures — eff. Effective October 1, 2020, eviCore healthcare (eviCore), an independent specialty benefit management company, will use updated Radiation Therapy Clinical Guidelines for Independence members. Cardiology Spring 2020 Keynotes; Clinical guidelines Coverage policies Health Fact. com or click here to access guidelines specific to Security Health Plan The eviCore healthcare (eviCore) evidence-based, proprietary clinical guidelines evaluate a range of advanced imaging and procedures, including NM, US, CT, MRI, PET, and Radiation Oncology, Sleep Studies and Cardiac and Spine interventions. 1, 2021, you can submit retroactive authorization requests to eviCore through April 30, 2021. If you would like to view all eviCore core worksheets, please type in "eviCore healthcare" as your health plan. New Guidelines: Guideline Name Radiation Therapy for Multiple Myeloma and Solitary Plasmacytomas - NEW Radiation Therapy for Thymoma and Thymic Cancer - NEW Radiation Treatment with Azedra® (iobenguane I-131) - NEW eviCore’s Radiation Therapy clinical guidelines are available on the Blue Cross website at providers. Specialty Drug Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program eviCore has released clinical guideline updates for the Radiation Oncology program. com or click here to access guidelines specific to Security Health Plan. After a one-time Radiation therapy may shrink a tumor, give you relief from cancer symptoms, or possibly cure cancer. 918. ASTRO Urges EviCore to Change Policy on Breast, Prostate Radiation Therapy Coverage. , a radiation oncology medical billing company headquartered in Tyler, TX , effective August 31, 2020 . 21 announcement that the Centers for Medicare and Medicaid Services (CMS) will delay the start date for the Radiation Oncology Model from January 1 to July 1, 2021, the American Society for Radiation Oncology (ASTRO) issued the following statement from Theodore L. Effective 10/01/2020. about accepted standards of care in radiation oncology, based on their review of sources such as the American Society of Therapeutic Radiation Oncology (ASTRO) coding guidelines and American College of Radiation Oncology (ACRO) practice management guide. Rajanish has 8 jobs listed on their profile. eviCore healthcare’s Clinical Guidelines and request forms are available at: www. For procedures with dates of service prior to Jan. We provide access to current, evidence-based, disease-specific analytics on all cancer types and treatment options, backed by board-certified oncology physicians and pharmacists. Decipher Biosciences, a commercial-stage precision oncology company committed to improving patient care, initially focused on urologic cancers, today announced that Decipher Prostate RP, studied in patients from the phase III, randomized controlled trial, RTOG 96-01, demonstrated the ability to accurately identify which prostate cancer patients with recurrent disease benefit most from anti-androgen hormonal therapy. utilization of high-value radiation oncology procedures (particularly IMRT) as well as the wide variation of coding and usage among radiation oncology practices. 360 Oncology leverages the NCCN Guidelines® to provide visual care pathways and track compliance. For information on how to submit a prior authorization request, please refer to MeridianComplete’s new authorization lookup tool: Oncology is a complex and rapidly changing health care specialty. A systematic literature review identified Proton beam therapy; Echocardiogram services; Medical oncology - for UAW Retiree Medical Benefits Trust non-Medicare members (for dates of service on or after Jan. Participation in the MROQC CQI. ASTRO Coding Question Submission Form ASTRO is pleased to offer our members the ability to submit questions pertaining to coding in daily practice. Call 1-888-693-3211 (TTY: 711) (7 AM to 8 PM CT, Monday through Friday). com > Prior Authorization and Notification > Oncology > Medicare Advantage Therapeutic Radiation Prior Authorization Program or call UnitedHealthcare Clinical Requests at . 0 _____ › Verified 2 days ago › Url: https://www. Medical Oncology Criteria. Perinatal guidelines Contact eviCore at 1-888-693-3211 • Automatic Implantable Cardioverter Defibrillators (AICD) • Advanced radiology services (CT, MRI, PET scans, echocardiography, stress echocardiography, cardiac nuclear medicine imaging, and radiation therapy) • Diagnostic cardiac catheterization • Chiropractic therapy* • Medical oncology (chemotherapy) Guidelines: 1. 3,319 likes · 37 talking about this. 1, 2, 3 Given its brief duration and favorable toxicity profile, the indications for and subsequent utilization of SRS has increased over time. com or click here to access guidelines specific to Security Health Plan. D. Cardiology Criteria. National Institute for Health and Clinical Evidence. Note: eviCore guidelines undergo a formal review annually; however, eviCore reserves the right to change and update the guidelines without prior notice. eviCore healthcare is a registered service mark of CareCore For medical necessity criteria, see eviCore Healthcare Radiation Therapy Clinical Guidelines. 2020 - Present 1 year Remote eviCore offers proven, diversified medical cost management solutions that help clients reduce costs while increasing quality of care for their members. Medical Prior Approval Requirements for COVID-19 related illnesses ar e based on the CDC’s official coding guidelines related to COVID-19. 2020 include: NSCL-19 • The following regimens added for the first-line treatment of patients with metastatic NSCLC and an EGFR mutation. Security Health Plan is partnering with eviCore to manage high end imaging, musculoskeletal procedures, outpatient therapy and sleep management. includes provider FAQs, code lists, clinical guidelines, and clinical worksheets (to help you understand eviCore’s clinical criteria). The Criteria for Year 4 (measurement period: 1/1/2020-09/30/2020; effective 3/1/202 1-2/28/2022) is listed below. Use the eviCore Provider Portal to submit prior authorization requests. com 855-727-7444 In addition, eviCore established coding and billing guidelines to help ensure appropriate billing of radiation oncology codes. services can be obtained using one of the following methods: The eviCore Healthcare Web Portal is available 24x7. Radiation Oncology. Therapeutic Radiopharmaceuticals . 504 Technology Review 10. Radiation Oncology guidelines: Modified: Important changes, effective September 24, 2020: Updated Radiation Therapy guidelines, which includes: * eviCore utilizes multiple sources to develop their Radiation Therapy Clinical Guidelines, including consultation with the Company, evidence-based guidelines, and recommendations from national and international medical societies, and evidence-based medicine research centers, including, but not limited to, American Society of Radiation Oncology * eviCore utilizes multiple sources to develop their Radiation Therapy Clinical Guidelines, including consultation with the Company, evidence-based guidelines and recommendations from national and international medical societies, and evidence-based medicine research centers, including, but not limited to, American Society of Radiation Oncology • Radiation Oncology Program Updates for Fully Insured Commercial and Medicare Advantage Subscribers- eviCore Healthcare Specialty UM Program (Effective 3/2/20, P2-20) • Radiology Oncology Imaging Clinical Guideline Updates for Fully Insured Commercial Getty Images. On July 1, 2020, eviCore healthcare ® will simplify the authorization process for radiation oncology by asking Clinical Decision Support questions, rather than their traditional clinical questions. com/paan . 511 Medical Policy and Clinical Guidelines: Definitions and Procedures 10. Frequently Asked Questions. Now, using a Evicore Radiation Therapy Worksheet takes at most 5 minutes. Through this pre-service Medical N ecessi ty Determination (MND) prgoram, eviCore helps us to The NCCN Radiation Therapy Compendium™ includes a full complement of radiation therapy recommendations found in the current Guidelines. Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program . CMS National Coverage Policy . with a current, active, U. Note: eviCore guidelines undergo a formal review annually; however, eviCore reserves the right to change and update the guidelines without prior notice. March 18, 2020 ASTRO has confirmed that eviCore will update its Radiation Oncology Guidelines to permit coverage for hippocampal avoidance (HA) whole-brain Intensity Modulated Radiation Therapy (IMRT). 2. The doctors at eviCore totally IGNORE the worlds top doctors explanations why they ordered a LIFE SAVING test, because they REPRESENT the INSURANCE COMPANY. Draft guidelines are posted 90 days prior to implementation. Leaders of the American Society for Radiation Oncology (ASTRO) urge eviCore, a radiation oncology benefits management company, to halt and make meaningful changes to a new policy for radiation therapy coverage. m The 2020 ASTRO Radiation Oncology Coding Resource eBook has been updated to reflect recent changes to radiation oncology coding. These updates, available starting today, include the addition of COVID-19 related coding guidance, updated language on Ambulatory Payment Classification (APCs), updated glossary terms and definitions and more. URGENT (same day) REQUESTS MUST BE SUBMITTED BY PHONE. S. Revis ed 6/20/2020 . 866-889-8054 The successful candidate will be an M. at eviCore. Radiation Therapy guidelines: Modified: Important changes effective September 24, 2020: In addition, eviCore established coding and billing guidelines to help ensure appropriate billing of radiation oncology codes. The Consolidated Appropriations Act, 2021 (H. 60 to 70% with chemotherapy and radiation therapy (Bartelink et al, 1997; Northover et al, 2010). Opioid Guidelines (new for 2020) ICSI Pain: Assessment, Non-Opioid Treatment Approaches and Opioid Management 8th Edition, August 2017: Version 2 , opens new window. DeWeese, MD, FASTRO, (pictured left) Chair of the ASTRO Board of Directors: The American Society of Clinical Oncology (ASCO) today released its review of leading oncology pathway vendors in the United States. Radiation Oncology Including Intensity Modulated Radiation Therapy (IMRT) Contractor's Determination Number . 518 Clinical Trials Select a hyperlink below to be directed to that section. The foundation of our solution platform for specialty benefits management is our clinical appropriateness guidelines. Guideline updates will become effective November 1, 2020: Please review all guidelines when submitting a prior authorization request. 0 © 2020 eviCore healthcareAll Rights Reserved. com | 400 Buckwalter Place Blvd • Bluffton, SC • 29910 | 800. Stereotactic radiosurgery (SRS) is a complex form of radiation therapy to treat benign and malignant central nervous system (CNS) diseases. Resources, then MVP/eviCore new Radiology Prior Authorization codes 03/01/2021. Oct. eviCore preauthorization’s for outpatient. For Commercial members receiving IMRT services, please see the Commercial Intensity Modulated Radiation Therapy Prior Authorization Program. 10. For guidance on brachytherapy at the end of a procedure new subsection, D1. To pre-certify a radiology, cardiology or radiation therapy procedure, please contact eviCore at 877-PRE-AUTH (877-773-2884) or visit the Prior Authorization and Notification tool (PAAN/ LINK). Access guidelines here for Blue Cross and Blue Shield members in Illinois, Montana, New Mexico, Oklahoma and Texas, and Blue Cross Community Centennial SM Medicaid members in New Mexico. Lab Management. Health Details: New finding on basic imaging study such as plain x-ray or ultrasound New finding on adjacent body area CT/MRI study (i. 31, 2021. Effective Date: Feb. 1199 Radiation Oncology Clinical Guidelines. Premium payment policy change and remittance code The American Society for Radiation Oncology issued the following news release on Oct. If you have any questions, please reach out to your health plan. We provide innovative solutions across the entire healthcare continuum. To pre-certify a radiology, cardiology or radiation therapy procedure, call eviCore at 1-877-PRE-AUTH (1-877-773-2884) or visit the Prior Authorization and Notification tool at UHCprovider. CY 2018 to CY 2019 Code Changes for Drugs Specific to Oncology/Hematology Services The following codes have been deleted for CY 2019: • 0190T: Placement of intraocular radiation source applicator (List separately in addition to primary procedure) • 76001: Fluoroscopy, physician or other qualified healthcare professional time Reviews from eviCore healthcare employees about working as a Clinical Reviewer at eviCore healthcare. There are no updates for Radiation Oncology Program Codes. . Which of these Canadian Rad Onc Training Programs are the best overall programs from the perspective of US staff? eviCore’s new logo is a graphic representation of how the company connects all the dots to address the entire spectrum of client needs, and the gradation of the dots denotes flexibility in Radiation Oncology Computed tomography guidance for placement of radiation therapy fields Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation RadMD is a user-friendly, real-time automated tool that gives instant access to advanced imaging, cardiac, physical medicine and other specialty procedure authorizations. Please help us! There are complaints all over the internet! There is an article in the Minneapolis paper dated 7/20/2020 regarding this exactly. 1, 2008 • Select radiation therapy procedures — eff. Refer to our guidelines (PDF) for authorizations managed by eviCore. , Sept. 80% of patients do not receive >10 fractions for treatment of bone metastasis in accordance with the ASTRO Choosing Wisely guidelines. Specialty Drug Management. Guidelines for radiation therapy, proton beam therapy, and radiopharmaceutical therapy are included below. 1, 2018, through Dec. Denosumab (Prolia ® and Xgeva ®) - (1212) Modified: Important changes in coverage criteria: CT Guidance for Placement of Radiation Therapy Fields 77014 Unlisted CT procedure (for radiation planning or surgical software) 76497 Nuclear Medicine CPT® PET Imaging; limited area (this code not used in pediatrics) 78811 PET Imaging: skull base to mid -thigh (this code not used in pediatrics) 78812 eviCore Healthcare authorization Non-emergent services Services Medicare line of business only • Hip, knee and shoulder procedures • Outpatient interventional pain injections and procedures • Molecular genetic lab • Medical oncology • Outpatient radiation oncology therapy Online: 24/7 myportal@evicore. For stage III, definitive external beam radiation therapy to a dose of 60-70 Gy in 30-35 fractions using a 3D conformal technique or intensity-modulated radiation therapy (IMRT) is considered medically necessary. eviCore is now using the updated Radiation Therapy Clinical Guidelines to determine the medical necessity for these services. Image-guided radiation therapy (IGRT) employs imaging to maximize accuracy and precision throughout the entire process of treatment delivery. will be making updates to reflect these changes on the authorization lookup tool www. 78430. Oncology Adult; Oncology Pediatric; Radiation Oncology guidelines: Modified: Important changes effective August 4, 2020: Added one new guideline for vulvar cancer. Asking eviCore healthcare for approval Go to eviCore. O. 26. 79005 Radiopharmaceutical therapy, by oral administration; used for I -131 treatment Coding Guidelines Prior Approval Codes. m. eviCore. The use of protons is produced by an accelerator (cyclotron, synchrotron, synchrocyclotron, or linear). eviCore is committed to providing an evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics, and sensitivity to the needs of everyone involved across the healthcare continuum. RAD-014 . As of October 1, 2020, eviCore healthcare (eviCore), an independent specialty benefit management company, has updated its Radiation Therapy Clinical Guidelines for Independence members. eviCore healthcare, Bluffton, South Carolina. The requested radiation therapy services are reviewed in accordance with applicable Medicare National and Local Coverage Determinations (for Medicare Advantage only), nationally recognized clinical and billing guidelines of the American College of Radiation Oncology, American Society of Radiation Oncology, other recognized medical societies CareCore National, LLC d/b/a eviCore healthcare (eviCore) Radiation Therapy Clinical Guidelines are based on evidence-based guidelines and recommendations from national and international medical societies, and evidence-based medicine research centers, including, but not limited to, American Society of Radiation Oncology [ASTRO], National Subsequently, on September 18, 2020, the Center for Medicare and Medicaid Innovation (CMMI) issued a final rule establishing a Radiation Oncology Alternative Payment Model (RO Model), effective January 1, 2021. The updates are as follows: eviCore Solution CPT/HCPCS Rationale for addition to UM Program Radiology 0609T 0610T 0611T 0612T These new T codes represent new technology promoted as a clinical Medical Policy #09. 02389 Journal of Clinical Oncology - published online before print September 18, 2020 . We performed an updated meta-analysis to assess how improvements in treatment over time have affected the impact of margins on local recurrence (LR) rates over time. 31, 2020 It applies only to Medicare Advantage members who are receiving intensity modulated radiotherapy (IMRT), stereotactic radiosurgery (SRS) or stereotactic body radiation therapy (SBRT) treatment. SAN DIEGO, Feb. e. The standards have also been expanded to include Radiation Oncology/Therapy providers. com or by phone at 1-888-693-3211 1-888-693-3211. "Oncology Clinical Pathways: Charting the Landscape of Pathway Providers," published in the Journal of Oncology Practice (JOP), examines the clinical pathways offered by six commercial vendors using the society's criteria for high-quality The optimal tumor-free margin definition and width following breast-conserving therapy (BCT) for early-stage invasive cancers has been evaluated in previous meta-analyses and guidelines. Radiation oncologists today expressed serious concerns about a new private insurance coverage policy that AIM Specialty Health radiation oncology clinical guidelines updates Oct 1, 2018 • Products & Programs Effective for dates of service on and after January 28, 2019, the following updates will apply to the AIM Specialty Health© (AIM) radiation oncology clinical appropriateness guidelines. A free inside look at company reviews and salaries posted anonymously by employees. That testing period has been extended through Dec. Independence has delegated the responsibility for utilization management activities for certain radiation therapy services to eviCore for commercial Independence members. Associate Medical Director of Radiation Oncology, eviCore Healthcare Jan 2012 - Oct 2020 8 years 10 months. evicore. , pleural effusion observed on CT abdomen) Oncology Imaging Guidelines V1. Radiation oncologists today expressed serious concerns about a new private insurance… The Criteria for year 2 (effective: 3/1/2019-2/28/2020) is included below. Adobe PDF Reader is required to view clinical worksheets documents. 0 In this post I link to eviCore Healthcare‘s CLINICAL GUIDELINES Pediatric Oncology Imaging Policy, Version 1. There are no procedure code updates to the Radiation Oncology program. state medical license and board certified in Radiation Oncology, recognized by the American Board of Medical And there are Evicore guidelines. A dose of 45 Gy to 59. eviCore is now using the updated Radiation Therapy Clinical Guidelines to determine the medical necessity for these services. 18, 2020 /PRNewswire/ -- Decipher Biosciences, a commercial-stage precision oncology company committed to improving patient care, initially focused on urologic cancers, today IMPORTANT REMINDER: Effective January 1, 2021, the following products will migrate to new systems and platforms:. Radiation Oncology Guidelines V3. Prostate cancer (V. While both healthy and cancerous cells are damaged by radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy cells as possible. Health Details: eviCore is committed to providing an evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics, and sensitivity to the needs of everyone involved across the healthcare continuum. com. October 2, 2020 — Radiation oncologists expressed serious concerns about a new private insurance coverage policy that could undermine patient-centered care for two of the most common cancers in the United States. Examples of questions eviCore’s team can answer: claims denied for no authorization, claims denied as units exceeding authorized services and services denied at the time IMPORTANT REMINDER: Effective January 1, 2021, the following products will migrate to new systems and platforms:. eviCore FAQs. • Breast Cancer • Prostate Cancer • Proton Beam Therapy eviCore has released clinical guideline updates for the Radiation Oncology program. The medical necessity of stereotactic radiosurgery (SRS) is nonuniform across insurance policies. Visit the dedicated AllWays Health Partners resource page on the EviCore website . The Guidelines and Pathways are designed to evaluate and direct the appropriate utilization of certain health care services. Please call the Client Provider Operations department at 1-800-646-0418, option 4, if you have any questions or need more information. Starting April 1, 2016, you must contact eviCore for prior authorization of radiation therapy services associated with the CPT/HCPCS codes on the […] G6001 Ultrasonic guidance for placement of radiation therapy fields G6002 Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy . Contact eviCore at 1-888-693-3211 • Automatic Implantable Cardioverter Defibrillators (AICD)* • Advanced radiology services (CT, MRI, PET scans, echocardiography, stress echocardiography, cardiac nuclear medicine imaging, and radiation therapy • Chiropractic therapy** • Diagnostic cardiac catheterization* eviCore. However, eviCore will begin accepting authorization requests on December 16, 2019 for dates of service beginning January 1, 2020. 1:. com‌. eviCore guidelines are based on a combination of medicare, best practice , and interqual. 2021 Radiation Oncology Coding Resource Updated for changes effective January 1, 2021, the Coding Resource is an essential coding reference for all radiation oncology practices. Leaders of the American Society for Radiation Oncology (ASTRO) urge eviCore, a radiation oncology benefits management company, to halt and make meaningful changes to a new policy for radiation therapy coverage. The American Society for Radiation Oncology (ASTRO) has announced the studies that will be highlighted in the 2020 ASTRO Annual Meeting press program. BlueCross BlueShield offers a wide variety of health coverage options, including managed care, preferred provider organization (PPO), point of service (POS) and traditional contracts to employer groups throughout western New York. Over 900 facilities have qualified for an ACR Lung Cancer Screening designation since the program’s inception. Code Description . 19 – 39. evicore. 3. View Rajanish Singla, MD’S profile on LinkedIn, the world's largest professional community. Radiology Criteria. D. Guidelines Clinical Practice Guidelines High-End Radiology, Radiation Therapy, Cardiac Devices & MSK (Musculoskeletal Services) eviCore Healthcare Information. 4 Gy in 25 to 33 fractions delivered in up to 3 phases is considered medically necessary. 18, 2020 /PRNewswire/ -- Radiation Business Solutions (RBS) announced that they reached an agreement to purchase RADMAX, Inc. Under the new policy, EviCore mandates that most breast and prostate cancer treatments use a shorter, hypofractionated radiation therapy regimen even if it runs counter to a physician’s clinical Acute Rehab Admission eviCore General information High End Imaging - Cardiac studies and elective heart catheterization High end imaging - radiation services Hospital admissions - pre-certification Hospital Observation Admission Sterilization: Hysterectomy Coverage Long term acute care admission Musculoskeletal procedures NaviHealth/Skilled Neoadjuvant radiation therapy is no longer medically necessary for patients with disease that is fully resectable. Musculoskeletal Imaging Policy. CT Abdomen and/or Pelvis CPT Codes (non-CTA). eviCore healthcare and P3 Health Partners are separate, independent companies that provide services to BCBSAZ providers and members. 5 – 17. All ICD-9-CM diagnosis codes must be coded to the highest level of specificity . Flexible medical benefits management solutions are offered in: Cardiology, eviCore onConnect SM (Comprehensive Oncology), Gastroenterology, Lab Management, Medical Oncology, Musculoskeletal, Post National Comprehensive Cancer Network. state medical license and board certified in Radiation Oncology, recognized by the American Board of Medical Refer to the Lab Resources page and select the BCBSOK health plan for the applicable CPT/HCPCS code list and radiation therapy physician worksheets. claims for SRS and other radiation treatments. Please call the Client Provider Operations department at 1-800-646-0418, option 4, if you have any questions or need more information. The reviewers are bound to evicore guidelines. Musculoskeletal Advanced Procedures. You can verify benefits and request prior authorization at Availity. The press program will feature studies on cancer treatment advances and discussions of topical issues including COVID-19 and racial representation in radiation therapy clinical trials. wellcare. For Outpatient Radiation Therapy, Molecular and Genomic Testing Preauthorizations refer to the eviCore tab. , October 1, 2020. (NICE). . The Standards include Federal and State laws and regulations, standards and guidelines applicable to outpatient radiology/diagnostic imaging services and standards established eviCore musculoskeletal program FAQ; eviCore healthcare’s Clinical Guidelines and request forms are available at: www. Apply for Associate Medical Director - Radiation Oncology - Work from home - eviCore job with Cigna in Melbourne, Florida, United States of America. Working at eviCore allows you to make a difference in people's lives by improving the quality of their healthcare. Many payers outsource their guidelines to eviCore, an NBM that pro-vides guidelines in lieu of the primary insurance payer. As an Associate Medical Director, you will feel intellectually stimulated and Supports unassigned medical codes impacting EviCore Oncology management process, as well as potential expansion to support unassigned (non-J9999) code precertification. Advanced Radiology Imaging 4. Use of accelerated whole bre ast irradiation (AWBI) in ≥90% of appropriate patients (per the eviCore has established a claim response team to address provider questions specifically related to claim denials for radiation oncology or outpatient therapy claims. Sleep Management Criteria eviCore Radiation Therapy Coding Guidelines These guidelines summarize definitions and appropriate use of several CPT® codes. Radiation Oncology contracting and consulting in areas of equipment selection, investment consulting, device design and professional radiation oncology services. eviCore Radiation Oncology Coding Guidelines. Where can I see eviCore healthcare’s radiation therapy coverage criteria? You can see eviCore healthcare’s clinical guidelines on radiation Proton beam therapy is a type of particulate radiation therapy that differs from conventional electromagnetic and/or photon radiation therapy. If prior authorization is denied or was not requested then ALL/ANY related angioplasty procedure will also be denied. CT Cardiac If CT Angiography is being requested, please see the CTA codes. Image Guided Radiation T herapy ( IGRT ) 4. The CDC guidelines may be found on ou r site or on the CDC site. 7, 2020 /PRNewswire/ -- Decipher Biosciences, a commercial-stage precision oncology company committed to improving patient care, initially focused on urologic cancers, today announced that eviCore Healthcare (eviCore), a healthcare decision Radiation Oncology. By contracting with ROBMs, private insurers seek to control the increasing costs of radiation treatment delivery while ensuring appropriate usage of these services. Radiology 2. 20. Medical Oncology 3. NIA's Radiation Oncology program can incorporate management of a wide range of treatments and services for all cancer sites, both primary and secondary malignancies. Radiation Oncology. or D. 8924 Diagnosis, if known or rule out: Oncology Analytics is a different kind of partner for oncology utilization management. MVP has delegated utilization management of chiropractic care, massage therapy, and acupuncture to Landmark Health care, Inc. Independence has delegated the responsibility for utilization management activities for certain radiation therapy services to eviCore for all commercial Independence members. 2. We provide innovative solutions across the entire healthcare continuum. PED-ONC-1: General Guidelines are on pp. DOI: 10. But it has risks for serious side effects. DBA eviCore health care MSK Services (Landmark). Radiation Oncology Predeterminations However, with our pre-built web templates, things get simpler. The American Society for Radiation Oncology (ASTRO) created a model policy based on the consensus of the radiation oncology community to communicate medically necessary indications for SRS. Radiation Therapy Clinical Guidelines. 1, 2020) and Blue Cross commercial fully insured members (for dates of service on or after Dec. S. The following services are bundled into the radiation therapy codes 77750-77799 except for procedure code 77776: AIM Specialty Health® (AIM) has developed proprietary Clinical Guidelines and Cancer Treatment Pathways (together with any updates, referred to collectively as the “Guidelines and Pathways”). 1, 2020. eviCore stated that staff are authorized to approve requests for HA whole-brain IMRT for appropriate patients while the guidelines are being updated. 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 9188924 - www. Posts about #eviCore written by KR2Medical Billing. AmeriHealth has delegated the responsibility for utilization management activities for certain radiation therapy services to eviCore for all commercial AmeriHealth members. com. Authorization Forms Providers: Click the authorization form you need to download it. Radiation Therapy (outpatient) (eviCore evidence-based Clinical Guidelines) Radiofrequency Ablation to Treat Uterine Fibroids Radiology (eviCore healthcare evidence-based Clinical Guidelines) Reconstructive and Cosmetic Procedures Sleep Studies (CareCentrix Guidelines) Specialty Medication Administration — Site of Care Speech Generating the request is urgent. Small Cell Lung Cancer: Fractions allowed for palliation were decreased from 15 to 10. Molecular Genetics Radiation Therapy 6. See full list on provcomm. NEW YORK, April 21, 2020 /PRNewswire/ -- AMC Health, the leading provider in telehealth and remote patient monitoring (RPM) technology, today announced that its expanded and longstanding Radiation Business Solutions (RBS) announced that they reached an agreement to purchase RADMAX, Inc. Musculoskeletal Therapies. Details: eviCore will provide Utilization Management programs for Radiation Therapy and Radiology/Cardiology for Horizon NJ Health and Horizon NJ Total Care (HMO D-SNP) members effective January 1, 2020. For more information, or to request prior authorization for radiation therapy, please go to UHCprovider. (IMPORTANT NOTE: After searching the Medicare Coverage Database, if no LCD/LCA is found, then use the above referenced policies. 2020). Learn about eviCore healthcare culture, salaries, benefits, work-life balance, management, job security, and more. Instructions on how/where to submit the completed form are included at the bottom of the form itself. Disease-specific, evidence-based criteria was developed by eviCore to manage the appropriate utilization of radiation therapy services. Our Radiation Oncology program can incorporate management of a wide range of treatments and services for all cancer sites, both primary and secondary malignancies. Clinical guidelines, treatment checklists and other tools specific to both ordering providers and radiation oncology facilities can be accessed below for selected cancer sites. com or 855-252-117 AIM Specialty Health® (AIM) has developed proprietary Clinical Guidelines and Cancer Treatment Pathways (together with any updates, referred to collectively as the “Guidelines and Pathways”). Durable Medical Equipment. Post Acute Care. SAN DIEGO, Oct. This process can include target and normal tissue delineation, radiation delivery, and adaptation of therapy to anatomic and biological and positional changes over time in individual patients. with a current, active, U. Stereotactic Radiosurgery (SRS)/Stereotactic Body Radiation Therapy (SBRT) OPEN THE GENERAL CLINICAL GUIDELINE EFFECTIVE AUGUST 17, 2020. Guideline updates will become . com. eviCore radiation oncology policies have been adopted for Horizon NJ Health. Guideline updates will become effective August 1, 2020: Please review all guidelines when submitting a prior authorization request. Musculoskeletal Management Criteria. Operations at Cigna MVP Health Care Radiation Oncology Procedure List (effective January 1, 2020) Category/ Grouping CPT ® Code CPT ® Code Description 00-Brachy Brachytherapy 01-Brachy 0394T HDR electronic brachytherapy, skin surface application, per fraction Radiation Therapy Management Program To help ensure our members are receiving the most clinically appropriate care, the Benefit Funds have partnered with eviCore healthcare (formerly CareCore National) to review certain radiation therapy services. PMID: 32946361 radiation oncology Guidelines for radiation therapies, including brachytherapy, image-guided radiotherapy, intensity-modulated radiation therapy, proton beam therapy, and therapeutic radiopharmaceuticals. R. S tereotactic Radio Surgery (SRS) , Stereotactic Radiation Therapy (SRT) or Updates in Version 2. 0, Effective February 14, 2020. 56k: Radiation Therapy Services includes a link to the Radiation Therapy Clinical Guidelines that eviCore uses and a list of procedure codes effective October 1, 2020. Radiation Oncology Quality Consortium (MROQC) collaborative quality initiative to provide gold carding for radiation oncology procedures for facilities who met specific criteria. The following codes will be added to EviCore Prior Auth list, effective 03/01/2021. These authorization changes may include services performed by the following vendor (s): • HealthHelp (Radiation Therapy, Medical Oncology) • EviCore (PT, OT, Sleep Medicine, Lab, Pain Management, Cardiology, Radiology) On 01/01/2020, WellCare Health Plans, Inc. Health and Human Services (HHS) HSS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, opens new window. Special treatment procedure and special physics consult: Oral cone endocavitary indication is removed. Aug. evicore. 01. Fax a request form (available online) to 1-844-822-3862. 5+ Year Member. For nearly two decades, New Century Health has provided peace of mind to payers by taking clinical and financial accountability for total oncology spending. Horizon Blue Cross Blue Shield of New Jersey c ollaborates with ev iCore healthcare to a dminister our Radiation Therapy program. Title XVIII of the Social Security Act section 1862 (a)(1)(A). However, eviCore will begin accepting authorization requests on December 16, 2019 for dates of service beginning January 1, 2020. evicre Lung IMRT policy: "Intensity-Modulated Radiation Therapy (IMRT) is not medically necessary. To learn more, click on the services below. Blue Cross Procedures Managed by eviCore for Blue Cross. These guidelines are not meant to be all-inclusive, but are meant to be used in Introduction. ) • Committee approval date: November 17, 2020 • Accessed November 11, 2020 5. Radiation Oncology Quality Consortium (MROQC) collaborative quality initiative to provide gold carding for radiation oncology procedures for facilities who met specific criteria. 2020 EviCore Prior Authorization EFFECTIVE 01/01/2020 1. Reference Evicore policy word-for-word in your notes, and they will have a difficult time denying. 01. See the complete profile on LinkedIn and discover Jan 2020 - Present 1 year 3 Render judgement and advise on radiation therapy utilization appropriateness based on medical necessity and treatment guidelines such as Evicore and NCCN The ACR Lung Cancer Screening Center program meets the CMS threshold for radiation dose per the final NCD. The NCCN Radiation Therapy Compendium™ is reviewed on a continual basis to ensure that the recommendations take into account the most current evidence. Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan. Sleep Disorders Diagnosis. 360 Oncology is designed to improve quality of care by providing clinicians access to the latest clinical information for making evidence-based treatment decisions at the point of care. A valid ICD-9-CM diagnosis code must be present on every claim. Intensity Modulated Radiation Therapy ( IMRT ) 2. Dec 29, 2014 70 72 Status (Visible) Radiation Oncology Nov 9, 2020 CT Guidance for Placement of Radiation Therapy Fields 77014 Unlisted CT procedure (for radiation planning or surgical software) 76497 Nuclear Medicine CPT® PET Imaging; limited area (this code not used in pediatrics) 78811 PET Imaging: skull base to mid -thigh (this code not used in pediatrics) 78812 Note: eviCore will continue to manage pain management and lumbar spinal fusion surgeries for Medicare Plus Blue members throughout 2020. For information on how to submit a prior authorization request, please refer to MeridianComplete’s new authorization lookup tool: The successful candidate will be an M. healthgolds. Radiation Oncology discussion forum. 517 Non-covered Services and Procedures 10. For medical necessity criteria, see eviCore Healthcare Radiation Therapy Clinical Guidelines. External beam photon radiation therapy using Three-dimensional conformal radiation therapy (3DCRT) or Intensity-Modulated Radiation Therapy (IMRT) is considered medically necessary for the definitive treatment of anal canal cancer. Centers and Diagnostic Dental Offices. MeridianComplete (Medicare-Medicaid Plan). 133) enacted on December 27, 2020 includes a provision that prohibits implementation of the Radiation Oncology Model prior to January 1, 2022, effectively delaying the start date by 6 months. Follow our simple steps to have your Evicore Radiation Therapy Worksheet ready quickly: In ≥65% lung cancer patients, ≥ 95% of the PTV receives ≥100% of the prescription dose AND the heart mean dose is ≤20 Gy 5. Policy above is adapted from eviCore imaging guidelines. Unfortu-nately, these policies do not reflect expert consensus guidelines regarding indications for SRS in determining coverage at the detriment of the patients. Contact Information. 2: Coronavirus Disease (COVID-19), which addresses chest CT. Health Details: Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide. com eviCore has released clinical guideline updates for the Radiation Oncology program. Section 12 - Product Information General Information. Radiation Oncology Guidelines V1. eviCore handles all pre-certification requests. com (after logging in, choose the CareCore National tab). Radiology. However, eviCore will begin accepting authorization requests on December 16, 2019 for dates of service beginning January 1, 2020. Our Radiation Oncology program can incorporate management of a wide range of treatments and services for all cancer sites, both primary and secondary malignancies. eviCore will use the updated Radiation Therapy Clinical Guidelines to determine the medical necessity for As of October 1, 2020, eviCore healthcare (eviCore), a specialty benefit management company, has updated its Radiation Therapy Clinical Guidelines for AmeriHealth members. ASTRO tells eviCore to fix one-size-fits-all hypofractionation requirement eviCore now mandates that most breast and prostate cancer treatments use a shorter, hypofractionated radiation therapy regimen, even if it runs counter to a physician’s clinical recommendation. eviCore Healthcare - Brevard County, FL. eviCore handles all pre-certification requests. CMS plans to provide additional information on the delayed implementation. The RO Model also includes significant payment cuts due to the payment methodology that involves discounts and withholds. Intensity-Modulated Radiation Therapy. O. eviCore healthcare | www. 1. Sept. Guidelines with substantive changes: Updated imaging guidelines for Chest Adult: Added new section 13. Updated three guidelines with changes in coverage: Image-guided radiation therapy (IGRT): Use of IGRT is based on medical necessity for specific diagnoses. Search by health plan name to view clinical worksheets. eviCore Clinical Guidelines. eviCore has released clinical guideline updates for the Radiation Oncology program. American Society For Radiation Oncology » Cpt Code And Guidelines For Ct CT Guidance & Misc. Radiation oncology for all outpatient and office services 3. This decision provides additional time for practices to implement clinical decision support systems (CDSMs). 31 Authorization of musculoskeletal surgical procedures, including orthopedic, pain management and Section 218(b) of the Protecting Access to Medicare Act of 2014 amended Title XVIII of the Social Security Act to add section 1834(q) directing CMS to establish a program to promote the use of appropriate use criteria (AUC) for advanced diagnostic imaging services. Community Guidelines العربية (Arabic) Varian's 360 Oncology™ care management platform integrates clinical workflow, decision support and adherence tracking based on leading cancer care guidelines. Added Sustol (granisetron extended-release) criteria. For outpatient radiation therapy in urgent situations only, treatment may be started without prior authorization; however the treatment must meet urgent/emergent guidelines. In addition, eviCore completes medical necessity reviews and authorizations for outpatient radiation therapy services. This section allows coverage and payment eviCore Oncology Imaging Guidelines - Effective 2/14/2020. We compared the current insurance policies for SRS with those of the ASTRO model policy. Correct Coding Initiatives apply . a, states: Brachytherapy is coded to the modality Brachytherapy in the Radiation Therapy section. Table 1. com Go Now • National Comprehensive Cancer Network Guidelines • Radiation Therapy Oncology Group eviCore may be reached at 1-800-918-8924 or at evicore. No change in coverage for either policy. Details: eviCore eviCore will provide Utilization Management programs for Radiation Therapy and Radiology/Cardiology for Horizon NJ Health and Horizon NJ Total Care (HMO D-SNP) members effective January 1, 2020. CT Guidance for Placement of Radiation Therapy Fields 77014 Unlisted CT procedure (for radiation planning or surgical software) 76497 Nuclear Medicine CPT® PET Imaging; limited area (this code not used in pediatrics) 78811 PET Imaging: skull base to mid -thigh (this code not used in pediatrics) 78812 Fax a eviCore request form (available online) to 1-888-693-3210; Resources. This applies to authorizations for breast, prostate and non-small-cell lung cancer. Tomotherapy 3. 1, 2016 , through Dec. PEDONC-2: Screening Imaging in Cancer: Predisposition Syndromes are on pp. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Visit the dedicated AllWays Health Partners resource page on the EviCore website . Background The FY 2020 ICD-10-PCS radiation therapy guidelines provide two specific clarifying instructions: coding brachytherapy at the end of a procedure and as a separate procedure. ibx. Leaders of the American Society for Radiation Oncology ( ASTRO) urge eviCore, a radiation oncology benefits management company, to halt and make meaningful changes to a new policy for radiation therapy coverage. evicore radiation oncology guidelines 2020