On Jan. 31, the ACR partnered with the Arthritis Foundation to host an Arthritis 101 Congressional briefing on Capitol Hill. Panelists educated new and returning members of Congress and their staffers about arthritis and other rheumatic diseases, the cost and impact of rheumatic disease to constituents and the U.S. healthcare system, and current policy challenges…
As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B, but when it’s used as an oral agent for rheumatoid arthritis, it’s covered by Part D. Early in the…
CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral primary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in the patient’s medical chart….
A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and…
The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…
2016 was an impactful year for ACR advocacy efforts. Last month we reviewed our advocacy accomplishments in 2016, accomplishments that benefited 100% of our members. However, more than 95% of ACR and ARHP members had not invested in RheumPAC by the conclusion of the 2016 ACR/ARHP Annual Meeting. Each year, many of the same dedicated…
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…
Did you know that the ACR holds an annual Knowledge Bowl competition in conjunction with the ACR/ARHP Annual Meeting? Two fellows, along with a faculty mentor, compete in two to three rounds of trivia, modeled on the television game show Jeopardy! For the past three years I have participated, along with my team, the University…
Charity Navigator, America’s largest and most-used independent evaluator of charities, has awarded the Rheumatology Research Foundation with its eighth consecutive four-star rating. The prestigious ranking is the highest possible award given out by Charity Navigator and recognizes good governance, sound fiscal management and commitment to accountability and transparency. Charity Navigator President and CEO Michael Thatcher…
When the controversial Medicare Part B Drug Payment Model final rule was not released by the Centers for Medicare & Medicaid Services (CMS) as expected before Nov. 21, it signaled an increasing likelihood of defeat for the proposed rule—a signal proved true on Dec. 15. A spokesperson for the CMS said, “After considering comments, CMS…