On April 1, the Centers for Medicare and Medicaid Services (CMS) announced the beginning of the 45-day Open Payments Review and dispute period, which will conclude on May 15. After the review period concludes, on June 30, CMS will publish 2015 payment data along with updates to the 2013 and 2014 data. If you are…
Rheumatology Research Foundation Creates Five-Year Strategic Plan
Dramatic advancements in research toward prevention and cure are at risk, as federal research funding for rheumatic diseases has declined by 40% over the past five years. With that, an alarming number of rheumatologists are preparing for retirement. To stop this worrying trend, a strategic plan for the next five years was developed to complement…
6 Tips for Writing a Good Clinical Case Report
“That’s a great case. Why don’t we write it up?” It’s a question I’ve heard many times throughout medical school, residency and fellowship. It’s typically intended to be more of a politely worded request than a rhetorical question. We must acknowledge that the process of writing, editing and submitting a case report is onerous, but it…
The ACR Joins Call for Dedicated Arthritis Research Funding to Help Veterans
Arthritis is the primary cause of disability among U.S. military veterans and the second most common reason for medical discharge from the U.S. Army. One in three veterans is diagnosed with arthritis, compared with one in five members of the general U.S. population. It is important to keep in mind that these statistics reflect only…
Rheumatology Coding Corner Question: Coding & Billing Basics
When reporting E/M service levels, if time spent counseling and/or coordinating care dominates the session, which of the following is true? Total time must be documented Greater than 50% of the time must be for face-to-face counseling and/or coordinating care The extent of the counseling and/or coordinating care must be documented All of the above…
Rheumatology Coding Corner Answer: Coding & Billing Basics
Take the challenge. 1. D: All of the above Rationale: Per CPT, if time spent counseling and/or coordinating care dominates the session, then total time must be documented; greater than 50% of the time must be for face-to-face counseling and/or coordinating care, and must be documented as such. Additionally, the extent of the counseling and/or…
The ACR, ARHP Develop National Research Agenda for 2016–2020
Since 2005, the ACR’s Committee on Research has been responsible for advancing the research goals of the organization and providing leadership in research and research training in rheumatology via the ACR’s Research Agenda. The ACR Research Agenda is designed to address critical areas of research in rheumatic diseases, including the need for new technology, new…
How to Decipher the American Medical Association’s Billing, Coding Processes
The American Medical Association consists of two key groups: 1) the Relative Value Scale Update Committee (RUC), which oversees the annual updates to the physician work relative values, and 2) the Current Procedural Terminology (CPT) Editorial Panel, which assigns new or revised codes in the CPT book. The CPT Process Current Procedural Terminology (CPT) was…
Self-Auditing Important for Rheumatology Practices
In its 2016 Work Plan, the HHS Office of Inspector General (OIG) outlined its plans for audits and evaluations of covered entities to work on creating a permanent and more structured audit program. In light of their focused effort, the Office for Civil Rights has indicated that they will concentrate on areas of high risk…
Rheumatology Coding Corner Question: Billing for Trigger Point Injection, Office Visit
A 35-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left and right shoulders and her neck. The pain is considerably worse in the morning. She denies any fever, cough or dyspnea. The physician performs a problem-focused exam….
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