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Articles by From the College

In Advocacy, Slow and Steady Wins the Race

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Earlier in the year, it seemed that healthcare reform was stopped in its tracks because of the Massachusetts Senate special election—which placed Republican Scott Brown in the seat held by the “Liberal Lion,” Edward M. Kennedy. The Senate Democrats lost their supermajority and the momentum to pass President Obama’s healthcare reform legislation subsided. But through strong lobbying by the president, Speaker Nancy Pelosi (D-Calif.), and Senate Majority Leader Harry Reid (D-Nev.), Congress passed the Patient Protection and Affordable Care Act (H.R. 3590)—comprehensive healthcare reform—on March 21, and the president signed the bill into law on March 23.

Coding Note

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As of January 1, 2010, Medicare eliminated both inpatient and outpatient consultation codes.

I Have the Data—Now What?

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Rheumatologists practicing in the current healthcare environment are experiencing unprecedented information flow, data management issues, and a rise in quality designations and pay-for-performance incentive programs. There is increasing pressure on rheumatologists to document or capture treatment concordance with guideline recommendations and best practices and to monitor gaps in care and patient outcomes. Unfortunately, some quality programs are not considered clinically meaningful, and even those that are often bring administrative burdens related to reporting, data aggregation, and analysis.

Technology and Pay-for-Performance

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Medicare and private payers are increasingly developing programs to reward physicians based on clinical benchmarks. As more payers embrace this approach, practices are looking to technology to help them manage complex reporting requirements.

Update on Meaningful Use

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On December 30, the U.S. Department of Health and Human Services (HHS) released the long-awaited proposed rule establishing the Electronic Health Record (EHR) Incentive Program, which lays out a set of standards, implementation specifications, and certification criteria for EHR technology. This program has been developed in response to the “American Recovery and Reinvestment Act” (ARRA), which authorizes the Centers for Medicare & Medicaid Services to provide a reimbursement incentive for physician and hospital providers who become “meaningful users” of an EHR.

Coding and Billing for Facet Joint Injections

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Billing and coding is not as easy as one might think. The rules are constantly changing—and the codes for facet joint injections, which have changed frequently over the years, are a prime example. To make sure your practice is in compliance, billers, coders, and physicians should remain informed of the correct coding guidelines for facet joint injections. No one in a physician’s practice should ever assume that, because they coded a procedure a certain way in years past, it is still the status quo. Every rheumatologist and his or her staff should understand the what, why, and where of facet joint injections.