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Articles by From the College

Final Quarter for 2017 MIPS Reimbursement Has Begun

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The final stage of reporting for the Merit-Based Incentive Payment System (MIPS) began Oct. 2, 2017, if you chose the option to report for 90 consecutive days. The MIPS transition year began Jan. 1, 2017, and runs until Dec. 31, 2017. If you subscribed to the Centers for Medicare & Medicaid Services’ (CMS) email, you…

Advocacy in the Social Media Era

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Advocacy efforts in the medical profession are evolving as technology evolves. The rise of social media, in particular, has brought about great change in the way organizations, such as the ACR, interact with Congress. At the 2017 ACR/ARHP Annual Meeting, Nov. 3–8 in San Diego, former Sen. Tim Hutchinson (R-Ark.) will discuss how to continue…

Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2

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Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…

Rheumatology Coding Corner Question: Prolonged Service without Direct Patient Contact, Part 2

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An established, 66-year-old male patient is seen in the office for a follow-up visit for his fibromyalgia. The physician makes the decision to prescribe venlafaxine for anxiety and depression, and gabapentin for nerve pain. After the visit, the physician informs his medical assistant (MA) to contact the patient’s insurance carrier because venlafaxine requires a prior…

Tips to Manage, Prevent Medical Billing Claim Denials

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Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…

Rheumatology Champions Call for Lower Prescription Drug Costs, and More in Meeting with Congressional Legislators

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ACR advocates recently returned to Capitol Hill to meet with members of Congress as part of the Advocates for Arthritis fly-in conference on Sept. 26. This annual event brings together rheumatology professionals to advocate on behalf of the rheumatology community. Core issues on which the advocates focused this year include lowering the out-of-pocket cost of…

MACRA: Tips & Tools for Rheumatology Staff

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All healthcare professionals who work in rheumatology had to start adapting to a new landscape of reporting and documentation on Jan. 1 of this year when the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act, or MACRA, began. As the changeover continues, the Sunday ARHP session, Your New Role in the Era of…

MACRA Has Arrived—& What You Do Now Counts

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Changes to reimbursement introduced by the Medicare Access and CHIP Reauthorization Act (MACRA) will affect your Medicare income for 2019. “Rheumatologists generally know that MACRA is up and running,” says Angus Worthing, MD, FACR, FACP, clinical assistant professor of rheumatology at Georgetown University Medical Center and chair of the ACR’s Government Affairs Committee. “Virtually every…

Rheumatology Advocates Visit D.C. to Act for Arthritis

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The ACR/ARHP’s annual fly-in to D.C. (#Act4Arthritis) was a huge success. More than 100 ACR/ARHP members and patients from across the nation attended meetings on Capitol Hill to advocate for people living with rheumatic diseases. In all, our advocates visited 138 Senate and House offices. This year’s fly-in on Sept. 25–26 coincided with the second-annual…