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….
Rheumatology Coding Corner Answer: Billing for Trigger Point Injection, Office Visit
Take the challenge. Correct Coding: 99213-25, 20552 Diagnosis: M79.70 There continues to be a lot of confusion on proper coding for trigger-point injections. Two CPT4 codes can be used: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Injection(s); single or multiple trigger point(s), three or more muscle(s). The CPT4 codes are based…
Rheumatology Patients Are Essential to the ACR’s Grassroots Advocacy
Over the past several years, the ACR has collectively ramped up its advocacy efforts. Under the leadership of the Government Affairs Committee and with the combined advocacy efforts of many ACR/ARHP members and their patients, we made considerable progress advancing priority issues in 2015. With the ongoing effort of ACR members and patients, we can…
Opinion: Rheumatologists Cautioned Against Wasteful Testing to Find Rare Diseases
What rheumatologist doesn’t love the good old zebra hunt? You know—the pursuit of diagnosing the extraordinarily rare disease purely through pluck and wits. The zebra hunt is almost a tradition, a perennial topic of polite, but subtly boastful, conversation among peers and the subject of numerous career-building case reports. The hunt also happens to be…
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