Rheumatology is a relatively small subspecialty, but our patients need us to be strong advocates for them, ensuring access to the care they need. That’s why the ACR is calling on all of our members to join the American Medical Association (AMA) or renew your membership. Without a unified voice, we have no voice. We’ve…
The ACR Advocates for More MIPS Points for RISE Use
On behalf of the rheumatology community, the ACR recently submitted an entry for a rheumatology-specific Clinical Practice Improvement Activity (CPIA) that, if accepted, will be included in the 2018 performance year. The CMS put a call out to the public for CPIAs in an attempt to make MACRA more meaningful for participating providers. The ACR…
CORC: The Uncomfortable Move from Fee for Service to Value
ACR members are spread out across the U.S., but we all work in the same place: the land of fee for service. FFS, as it’s known to policy nerds, poses certain problems for cognitive subspecialists like rheumatologists. For instance, much of the work we do—calling providers and patients, coordinating care after hours—often isn’t compensated. And…
2017 Proves There’s ‘Power in Numbers’
RheumPAC’s first quarter progress indicates that it’s right on track to meet its monetary goals, but it’s not just about the money.
Insurance Subcommittee Responds to Health Plan Complaints
The ACR Insurance Subcommittee (ISC) regularly engages with insurance companies to discuss concerns raised by ACR members and advocate for appropriate coverage and payment policies. The ISC has gotten off to a busy start in 2017, working on a variety of patient access and reimbursement issues. Two recent issues the ISC has taken action on…
Rheumatology March Coding Corner Answer: Pediatric Rheumatology Consult
Take the challenge. CPT: 99203 This encounter is coded as 99203, because it included: History—The history of present illness was extended. The review of systems was complete, and the past medical, family and social were documented. This makes the history comprehensive. Examination—Expanded detailed. Medical decision making—The diagnosis was a new problem with no additional workup…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
On the Road in Rajasthan: Vehicular-Caused Bone, Joint Damage in India
In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…
Undercoding Is Not an Audit-Proof Strategy in Medical Documentation
Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
RheumPAC Committee Outlines Goals for 2017
“You can’t win last night’s game again.” —George Karl, professional basketball player and coach Amid the angst and upheaval from our recent elections and associated uncertainty for future healthcare policies, one thing remains clear: We must increase our engagement with our elected officials to educate them on the needs of our profession and our patients….
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