On May 11, ACR leaders representing the Board of Directors, Affiliate Society Council, Government Affairs Committee (GAC), Committee on Rheumatologic Care, RheumPAC Committee and Insurance Subcommittee went to Capitol Hill to advocate on behalf of the ACR/ARHP membership and our patients. The group, which represents 27 states and the District of Columbia, conducted meetings in…
In recent years, providers and practice groups have been worrying about Meaningful Use (MU) and gaining knowledge on using certified electronic health record (EHR) technology to avoid payment penalties, earn incentives and increase practice efficiency. Now, with the release of the final rule for MACRA payment reform, physicians will have two options for payment paths:…
Take the challenge. B—Most employer insurance plans change on Jan. 1. Because of this, it is a best practice for medical office staff to ask if there is any change to a patient’s medical coverage. Even if the patient indicates there are no changes in coverage, staff should still request to review their insurance card….
An established patient is seen in the office for a scheduled visit with the rheumatologist at the start of the new year. What should the front desk staff do for all patients at the beginning of each year? Inform the patient that their co-pay is due prior to receiving treatment, and ask how they would…
The Rheumatology Research Foundation is now offering the Innovative Research Award for Community Practitioners; tailored for physicians interested in disease investigation, it supports research ideas specific to clinical practice. The distinct perspective of clinical rheumatologists opens a window of opportunity for disease investigation that merits support for novel research. With the increasing prevalence of rheumatic…
In early March, the Centers for Disease Control and Prevention (CDC) released a new report showing that the number of Americans living with arthritis is at an all-time high. According to the report, 54 million Americans now live with arthritis, and approximately 79 million will have arthritis by 2040. This stark picture comes at a…
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Administrative Contractors (MACs) that process Medicare Part B claims have begun informing providers of their participation status in the Merit-Based Incentive Payment System (MIPS). This information is coming in the form of hard-copy letters that started mailing in late April and will continue…
Effective May 22, 2017 Noridian has updated the Local Coverage Determination (LCD) coding guidelines for CPT procedures 20552, injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) and 20553, injection(s); single or multiple trigger point(s), 3 or more used to affect therapy for a pathological condition. Noridian states the goal of the updated diagnostic…
An 82-year-old female established patient diagnosed with ankylosing spondylitis in multiple joints returns to the office for her second infliximab infusion. She denies any fevers, cough or concurrent illness. Her joint pain is 7 on a scale of 1–10. She complains of achy pain in the cervical, lumbar and sacral regions of her spine. She…
Take the challenge. CPT: 99214-25, 96413, 96375, 96361-59, J1745 x 4 J1745 JW* x 36, J1200 x1 ICD-10: M45.09, T50.995A, R06.02, E66.3, Z68.2 Rationale Modifier 25 is appropriate to use because it indicates the patient received a significant, separately identifiable E/M service on the same day as the infliximab infusion. This E/M service entailed the…