On May 16 and 17, ACR/ARHP leaders serving on the Board of Directors, Affiliate Society Council, Government Affairs Committee, Committee on Rheumatologic Care, RheumPAC Committee and Insurance Subcommittee once again went to Capitol Hill to advocate on behalf of ACR/ARHP members and their patients. The group represented 27 states and the District of Columbia, and…
Articles by From the College
It’s Time to Register for the 2018 ACR/ARHP Annual Meeting
Attended by over 15,000 rheumatology professionals from over 100 countries, the ACR/ARHP Annual Meeting is the largest rheumatology meeting in the world and the premier educational event for physicians, health professionals and scientists who treat or research rheumatic and musculoskeletal diseases. The 2018 Annual Meeting will be held Oct. 19–24 in Chicago. Attendees will be…
Foundation-Funded Researchers Study Pneumonia Risk, Doc Shortages, Decision Making
In the coming fiscal year (July 1, 2018–June 30, 2019), the Rheumatology Research Foundation has committed to fund more than $9.4 million in rheumatology research and training. Approximately half of the awards will support efforts to recruit and train the next generation of rheumatology professionals. The remaining funds will be awarded to advance research projects…
Rheumatology Coding Corner Answer: Medical Chart Review of an Infliximab Infusion
Take the challenge. CPT codes: 96413, 96415, 96375, J1745x30, J1200x1 Diagnosis ICD-10: M05.79 With the total infusion time of two hours and 13 minutes, CPT code 96413 is used to code for the first hour of the infusion and 96415 for the additional hour. The infusion would have to be 31 minutes into the next…
Coding Corner Question: Medical Chart Review of an Infliximab Infusion
A 73-year-old female established patient with rheumatoid arthritis affecting multiple joints and with positive rheumatoid factor returns to the office for an infliximab infusion. She denies any fevers, cough, dyspnea or concurrent illness. She has joint pain of 6 on the pain scale. She is on an NSAID, weekly methotrexate subcutaneous injections, folic acid and…
Joint Efforts: RheumPAC Facilitates Progress
Advocacy and RheumPAC staff from the ACR and other medical specialty organizations gathered in Nashville this month to discuss the importance of making sure your members know the details of the work advocacy and the PAC are doing. Thus far, the ACR has had a very successful year in terms of its advocacy efforts. Following…
UnitedHealthcare Implementing Risk Adjustment Audit Program
Beginning in June 2018, UnitedHealthcare (UHC) will implement their risk adjustment data validation (RADV) audit program. UHC states that through the mandatory requirement by the U.S. Department of Health and Human Services (HHS), Medicare Advantage health plans will be reviewed for supporting medical documentation to check for accurately reported patient data. UHC will send requests…
ACR/ARHP Members Call on Congress to Restore Patients’ Voices
WASHINGTON, D.C.—The ACR hosted the 2018 Advocacy Leadership Conference in Washington, D.C., on May 16–17. Rheumatology professionals from around the country flew to our nation’s capitol to attend the conference, where advocates heard from key policymakers and spoke with lawmakers about the issues that affect the rheumatology community—and what ACR/ARHP members can do to influence policy….
Avoid Billing Risks for New vs. Established Patients
When coding evaluation and management (E/M) services provided to a patient, one of the most persistent concerns is whether a patient is new or established to the practice. Although this may seem like a simple coding answer, the distinction is an important one, because it enables providers to appropriately bill and receive reimbursement correctly. E/M…
Rheumatology Coding Corner Answer: Billing for an Inflectra Infusion
Take the challenge. CPT codes: 96413, 96415, 96375, Q5103x20, J1200 ICD-10: M07.9 Coding Rationale This procedure is billed with CPT code 96413 for the initial hour of the intravenous infusion and CPT code 96415 for each additional hour. The patient was given 50 mg of diphenhydramine prior to the infusion to prevent reactions and should…
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