We previously alerted you to a CMS-proposed change that would cut reimbursement for the complete diagnostic musculoskeletal ultrasound (MSUS) significantly. We are pleased to report that, in its final rule, the CMS reversed that decision, and providers will see a reasonable reimbursement for the exam. The ACR advocated on your behalf for this change through…
Virtual Groups: Another Option for Reporting MIPS Participation through RISE
RISE now has three means of reporting through the Merit-Based Incentive Payment System (MIPS): individual, group and the recently added virtual groups. According to the CMS, virtual groups allow individual MIPS-eligible clinicians or groups consisting of not more than 10 MIPS-eligible clinicians to join together and report as if they were a single entity. The…
The ACR Lobbies Against New Part B Drug Cost Adjustment Rule
The ACR and a number of other physician medical associations are lobbying for an immediate legislative fix to a piece of the MACRA law that factors high-cost Part B drugs into a rheumatology practice’s Medicare reimbursement rate through the Merit-Based Incentive Payment System (MIPS). This change, which goes into effect immediately, will impact practices in…
RISE: What’s New for You in 2018?
Medicare’s Merit-Based Incentive Payment System (MIPS) has been on a gradual incline toward requiring full participation by eligible providers. During its transition stage, reporting for the first year (2017) allowed providers the option to report as partial, full, minimum or not at all, with varying degrees of penalties and incentives across all three reporting components:…
Rheumatology Coding Corner Answer: Evaluation for Possible Systemic Lupus Erythematosus
Take the challenge. CPT codes: 99245/99205 ICD-10: M79.1, R21, R53.83, L65.9, K13.79, R00.0 This visit can be billed out as a 99245 only if the insurance carrier allows the billing of consultation codes. If the carrier does not allow consult codes, then this visit must be billed as a new patient visit. Because many outpatient…
Rheumatology Coding Corner Question: Evaluation for Possible Systemic Lupus Erythematosus
History A 25-year-old female patient is seen in the office after her primary care physician requested a consultation for a possible diagnosis of systemic lupus erythematosus (SLE). The patient presents today with muscle pain in both legs, she rates the pain at an 8 on a scale of 10. She states she experiences throbbing, usually…
Rheumatology Future Physician–Scientist Award Available for MD/PhD Students
The Rheumatology Research Foundation is now offering the Rheumatology Future Physician-Scientist Award to enhance the training of promising MD/PhD or DO/PhD students who intend to become physician-scientists. As part of the Foundation’s work to recruit and train the next generation of rheumatology professionals, the award supports the nation’s top emerging physician-scientists. S. Louis Bridges Jr., MD,…
ACR Monitoring Saline Supply Shortage Due to Hurricanes in Puerto Rico
The ACR is aware of the shortage of intravenous saline solutions produced in Puerto Rico that is beginning to emerge across the U.S. and in rheumatology practices. In September, Hurricanes Irma and Maria wreaked havoc on the island, wiping out the island’s power grid and greatly hindering saline solution production. Puerto Rico produces about 10%…
AMA Workshop Focuses on Alternative Payment Models
On Oct. 4 in Chicago, the AMA hosted its second workshop on alternative payment models (APMs). The conference room was packed with providers and staff from specialty societies ready to listen to a whole day’s worth of APM presentations from professionals in the field. To kick off the meeting, AMA President-Elect Barbara McAneny, MD, welcomed…
Final Quarter for 2017 MIPS Reimbursement Has Begun
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…
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