Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…
Articles by From the College
Coding Corner Answers: Rheumatology Word Search
Take the challenge. Ultrasound guidance: There must be a permanent picture placed in the patient’s medical chart to meet the requirements of documentation guidelines. Arthrocentesis: This is the proper term for the withdrawal of fluid and/or injection of medication into a joint. If both the aspiration and injection are performed during the same encounter, only…
Coding Corner Questions: Rheumatology Word Search
Find the words/terms suggested by the following clues: What is the procedure conducted when a permanent picture is required for a joint injection? What is another name for a joint injection? What should be done when a patient returns for an infusion and a prior authorization has already been approved? On what body system is…
Common Issues That Lead to Claim Denials
In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices. Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…
Rheumatology Research Foundation Names Honorary Board of Advisors
The Rheumatology Research Foundation’s Honorary Board of Advisors is reserved exclusively for individuals who have made a transformative contribution, via a significant donation or through leadership, leaving an indelible mark on the organization’s future fundraising success. This year, Audrey M. Nelson, MD, from the Mayo Clinic, and ACR Executive Vice President Mark Andrejeski were named…
Association of Rheumatology Professionals: New Name but the Commitment Remains the Same
Rheumatology is truly a people specialty: We often develop lifelong relationships with our patients as well as our colleagues. We increasingly recognize that providing the best rheumatologic care requires a team effort. The collegial nature of our specialty is reflected in the ACR’s mission statement: To empower rheumatology professionals to excel in their specialty. In…
Year in Review: The Impact of Advocacy & RheumPAC in 2018
In 2018, did you interact with the Medicare payment system, receive payment for a consultation code or worry about the Centers for Medicaid & Medicare Services (CMS) reducing reimbursement through its proposal to combine evaluation and management codes in the Physician Fee Schedule? If your answer to any of those questions is yes, then you…
2019 Changes to E/M Documentation
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
ACR Delegates Move Rheumatology Concerns Forward at AMA
At the AMA’s recent House of Delegates Interim Meeting, the ACR’s delegation was able to incorporate rheumatology concerns into official AMA policy, in addition to leading a major multi-specialty resolution on the CMS-proposed move to consolidate and cut evaluation and management (E/M) services. The ACR is able to make this progress because members of the…
Up to Date with the HIPAA Privacy Rule
Throughout a patient’s lifetime, providers are entrusted with their most intimate and personal information, which they expect to be kept private and confidential. Unfortunately, the healthcare system can face serious implications if any part of a patient’s privacy or information is breached. Under the Health Information Portability & Accountability Act (HIPAA) and state laws healthcare…
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