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Articles by From the College

UHC Expands Pilot Lab Benefit Management Program

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UnitedHealthcare recently announced plans to expand its pilot Lab Benefit Management Program to Texas, as of March 1, 2017. The pilot program, which is administered by BeaconLBS, was first launched in Florida in October 2014. Under the pilot, providers are required to use a tool called Physician Decision Support to order certain labs for UHC…

Advocacy Spotlight: Dr. Matt Heinz, Candidate for Congress from Arizona District 2 (Tucson)

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RheumPAC is the ACR’s political action committee dedicated to increasing rheumatology’s presence on Capitol Hill. It is the only PAC dedicated to the interests of all rheumatologists and their patients. RheumPAC began in 2007 with the purpose of building contacts, influence and visibility within Washington, D.C. for rheumatology. RheumPAC works to support and elect pro-rheumatology…

Rheumatology Coding Corner Answer: Level 4 New Patient Visit

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Take the challenge. Correct Answer: CPT: 99204 ICD-10: I73.00 Coding Rationale This is a new patient, outpatient visit for a self-referred patient. There is no formal consultation request from another physician; therefore, the encounter does not meet criteria for a consultation. This encounter is coded as 99204 because it included: Comprehensive history—Extended history of the…

Rheumatology Coding Corner Question: Level 4 New Patient Visit

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A 32-year-old female patient comes in for an initial visit. She is self-referred and complains of pain, numbness and color changes in her fingers when exposed to cold. The patient reports that her right distal index finger, left distal index finger and fourth right finger turn white and blue with pain and numbness when exposed…

ACR Seeks Advisors for AMA/Specialty Society RUC and CPT Committee

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The ACR is searching for practicing physicians interested in coding and reimbursement issues to represent the ACR on the AMA/Specialty Society Relative Value Scale Update Committee (RUC) and Current Procedural Terminology (CPT) Committee. The RUC and CPT Committee comprise physicians representing the national medical specialty societies who advise the CPT Editorial Panel on matters concerning…

Rheumatology Research Foundation Investigators’ Meeting Shares Advancements Toward a Cure

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The Rheumatology Research Foundation hosted the 9th annual Investigators’ Meeting in Atlanta on June 24–25. As a requirement for Foundation innovative research and pilot grant recipients, Foundation-funded investigators meet annually to provide updates and status reports on the work they are doing to advance treatments and cures for rheumatic diseases. More than 50 attendees enjoyed…

2016 ACR/ARHP Pre-Meeting Educational Workshops to Cover MACRA, Merit-Based Incentive and Alternative Payment Models

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Looking for a reason to attend the 2016 ACR/ARHP Annual Meeting, which will be held Nov. 11–16 in Washington, D.C.? This monumental meeting will offer a variety of sessions on MACRA/MIPS/APMs, Medicare Value-Based Payment Reform programs, auditing, compliance and coding. Particularly, the pre-meeting workshops will provide you with the unique opportunity to dive deep into…

Rheumatology Coding Answer: Level 3 Established Patient Evaluation and Management Office Visit

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Take the challenge. CPT: 99213 Diagnosis Codes: M05.79, M17.12, Z79.1, Z79.899 Rationale to code this encounter as 99213: History—The history of present illness was extended. The review of systems was comprehensive, and two of the three past, family and social history were documented. This makes the history level comprehensive. Eight systems were examined. This makes…