From the College, Author at The Rheumatologist

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Coding Corner Question: To Bill or Not to Bill an Eval & Management Visit?

From the College | August 17, 2018

Scenario 1 History: A 45-year-old male patient with sero-negative rheumatoid arthritis affecting multiple sites, but with no organ or systems involvement, comes for a follow-up visit. The patient reports swelling of the left knee with throbbing left knee pain. He rates the severity of his pain at an 8 on a 10-point scale. The pain…

Submit Your Late-Breaking, High-Impact Rheumatology Studies Now

From the College | August 17, 2018

It’s time to submit your most outstanding emerging studies. The late-breaking abstract category allows for the submission of truly late-breaking, high-impact scientific research for which no preliminary data were available at the time of the June 5 general abstract submission deadline. Late-breaking abstracts should present data that are high impact, groundbreaking, innovative and newsworthy. Late-breaking…

The Choose Rheumatology Experience Addresses Workforce Shortage

From the College | August 17, 2018

Medical students and residents are choosing careers in rheumatology, thanks to an annual event hosted by the Rheumatology Research Foundation during the ACR/ARHP Annual Meeting. The Choose Rheumatology Experience, formerly known as the Student and Resident Experience, is a daylong event designed to help future physicians and health professionals navigate the Annual Meeting. Cultivating interest…

2019 Proposed Rule for MIPS Performance Year 3

From the College | August 16, 2018

The CMS has submitted its annual proposed rule, which continues the transition to a value-based model, for comment by stakeholders and the public for the 2019 MIPS performance year (Jan. 1–Dec. 31, 2019).

UHC Announces New Policy on National Drug Code Requirement

From the College | July 19, 2018

Effective Sept. 1, 2018, United Healthcare’s (UHC) new policy for National Drug Code (NDC) reimbursement will require providers to include additional drug-related codes submitted on the CMS-UB04 and the Electronic Data Interface (EDI) transaction 837i. All outpatient claims submitted to UHC commercial and UHC Medicare Advantage plans with a date of service on or after…

How to Document the Physical Exam

From the College | July 19, 2018

The adage frequently cited in healthcare settings, “If it isn’t documented, it wasn’t done,” still rings true for the key components required in a patient’s medical record. The note in the medical record must sufficiently describe all of the services furnished to patients on a specific date. The essential requirements to appropriately bill a claim…

Coding Corner Answer: Evaluation & Management Documentation Quiz

From the College | July 19, 2018

Take the challenge. B—The presenting problem(s) is what is evaluated during the history and examination by the provider. The chief complaint is in the patient’s own words or is a follow-up for his or her current condition. The history of present illness, along with the review of systems, usually guides the provider through the examination….

Coding Corner Question: Evaluation & Management Documentation Quiz

From the College | July 19, 2018

Evaluation & Management Documentation Quiz What element drives an evaluation and management (E/M) visit? The chief complaint in the patient’s own words of why he or she is in the practice for that date of service. The presenting problem(s) being discussed with the physician for that patient during the visit. The examination performed on the…

CMS Releases 2018 MIPS Eligibility Tool

From the College | July 19, 2018

You can now use the updated Centers for Medicare & Medicaid Services (CMS) MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-Based Incentive Payment System (MIPS). Enter your National Provider Identifier (NPI) in the tool to find out whether you need to participate during the 2018 performance year. Changes to…