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Articles by From the College

Rheumatology Coding Corner Question: Billing for an Inflectra Infusion

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A 68-year-old female patient returns to the office for a second round of Inflectra (infliximab-dyyb) infusion for her rheumatoid arthritis with rheumatoid factor of multiple joints without organ or systems involvement. She reports pain, stiffness and swelling in her left and right knees and right elbow and rates the pain at a 9 on a…

ACR Praises Congress for Bill with Part B Fix, Therapy Caps Repeal

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The ACR praises Congressional leaders for passing the sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauds the inclusion of provisions that permanently repeal Medicare…

Funding Available for Community Practitioners from the Rheumatology Research Foundation

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Few opportunities exist for rheumatologists in community-based practice who, in addition to taking care of patients, want to test their own observations through research. Limited funding, time constraints and competition from larger academic medical centers are some of the barriers hindering clinical research in this setting. The Rheumatology Research Foundation is addressing this issue with…

Rheumatologists: Participate in the ABMS Certification Conversation

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The ACR continues to actively advocate for certification reform and recently testified to the Continuing Board Certification: Vision for the Future Commission. The Commission is leading a collaborative effort to assess the current state of continuing board certification, and to envision a framework that is relevant and meaningful to physicians, patients, hospitals and health systems….

CMS Releases 2018 MIPS Eligibility Tool

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You can now use the updated 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 Low-Volume Threshold To reduce the burden on…

5 Ways You Can Get Involved During Arthritis Awareness Month

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The ACR’s 2015 Rheumatology Workforce Study Report projects a shortage of 3,800 rheumatologists in the U.S. by 2040. Given the projected rise in the number of adults with arthritis and the anticipated shortfall in the supply of rheumatologists, it is more important than ever to raise awareness about the benefits of early intervention, timely referral and specialized care by a rheumatologist. The ACR’s Board of Directors and advocacy team will be in Washington, D.C., this month to let legislators know how their decisions affect your practices and patients. You can take action—no matter where you are—to help us spread our advocacy messages throughout the month…

Rheumatology Coding Corner Answer: RA Follow-Up with Imaging

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Take the challenge. CPT codes: 99214, 71045, 86580 ICD-10: M05.79, R05, R06.2 History—Detailed: The history of present illness (HPI) was extended; the review of systems (ROS) was extended; and the past medical, family and social history (PFSH) were documented. All three components of the HPI, ROS and PFSH are needed to achieve the detailed history…

Rheumatology Coding Corner Question: RA Follow-Up with Imaging

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History A 39-year-old woman returns for follow-up for her rheumatoid arthritis. She has positive rheumatoid factor, but no organ or systemic involvement. She has joint swelling and pain in her left hand, right elbow and right knee. Her pain is at an 8 on a 10-point scale. She states the pain is worse in the…

Medicare Participation—Do Physicians Have Options?

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Physicians have three contractual options when it comes to the Medicare program: participating, non-participating and opting out. Providers should keep the old saying “look before you leap” at the forefront when considering opting in or out of the Medicare program. Since 2001, physician costs have been on the rise, with only mini­mal increases in reimbursements,…