Take the challenge. A—The commercial insurance coverage is primary in this situation. Medicare should be billed secondarily because it will not become primary until after the first 30 months of ESRD Medicare entitlement. After that, Medicare will be primary no matter the patient’s employment status. C—Unless the patient has a qualifying condition, such as ESRD,…
Coding Corner Question: An Insurance Billing Quiz
A 55-year-old male patient diagnosed with generalized osteoarthritis and diagnosed with end stage renal failure (ESRD) 20 months previously presents to the office to see the rheumatologist. The patient has a commercial insurance plan and Medicare. Which carrier is primary for this visit? Commercial insurance carrier Medicare You do not know because it is not…
Pediatric Rheumatology Learning at the 2019 ACR/ARP Annual Meeting
At this year’s ACR/ARP Annual Meeting, Nov. 8–13, all of the pediatric rheumatology sessions will take place in the same room, making it easy to access all of the exciting content. Planners hope this convenient setup facilitates networking before and after symposia. “In pediatric rheumatology, we are very tight-knit community. This [event] is our opportunity…
Annual Meeting Preview: Rheumatology Research Foundation Activities
Another exciting ACR/ARP Annual Meeting is planned for this November. Show your support for the Foundation’s mission and enjoy your time in vibrant Atlanta at one of the Foundation’s events. Donations made to the Foundation support the extensive awards program that funds research, training and education opportunities for current and potential rheumatologists and rheumatology professionals…
The Registry Built for Rheumatology: RISE User Appreciation at the ACR/ARP Annual Meeting
Get your questions about RISE answered on site at the 2019 ACR/ARP Annual Meeting—and pick up a voucher for free coffee.
Coding Corner Answer: Is This Shoulder Ultrasound Billable?
Take the challenge. Answer: No, if billed as incident-to for the NP. Note: The patient’s current insurance carrier is Blue Cross Blue Shield of Massachusetts (BCBS of MA). Under BCBS of MA, nurse practitioners and nurse practitioner primary care providers are not allowed to perform or interpret radiology services. Therefore, the physician would have to…
Coding Corner Question: Is This Shoulder Ultrasound Billable?
A 32-year-old male patient with rheumatoid arthritis affecting multiple joints without rheumatoid factor returns to the office for a follow-up visit with the nurse practitioner (NP). The patient states his overall pain has improved since his previous visit, although he rates the severity of his right shoulder and right wrist pain at a 5 on…
Best Practices for Onboarding New Physicians
A lot of effort goes into recruiting the best provider into a practice, but missteps during the onboarding process have the potential to leave the provider feeling unsatisfied and the practice dealing with turnover. Although it is one more task to add to an already full plate of things to do at a practice, comprehensive…
RheumPAC Advocates for Dept. of Defense Arthritis Research Funding
RheumPAC is the ACR’s non-partisan political action committee, which promotes the needs of rheumatology providers and patients. Advocacy efforts often focus on legislation to improve the day-to-day clinical care of rheumatology patients, such as establishing clinical exceptions to step therapy requirements and reforming the prior authorization process. In addition, the ACR and RheumPAC recognize the…
Rheumatology Research Foundation Hosts Annual Investigators Meeting
The Rheumatology Research Foundation hosted the 13th annual Investigators Meeting in Washington, D.C., June 22‒23. The meeting provides Foundation-funded researchers with an opportunity to share updates on their studies, network, exchange ideas and collaborate on future projects to advance treatments and cures for rheumatic diseases. More than 50 rheumatology professionals were in attendance, with presentations…
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