Cigna will not move forward with changes to their reimbursement policy for evaluation and management (E/M) codes submitted with modifier 25 as originally scheduled.
New HCPCS Code Added for Anifrolumab-fnia, 1 mg
Effective for dates of service on or after April 1, the Healthcare Common Procedure Coding System (HCPCS) code J0491 is valid for billing 1 mg anifrolumab-fnia.
New No-Surprises Rules May Affect Rheumatology Services at Hospitals
This month, we offer an overview of the federal No Surprises Act, which stipulates that healthcare insurers may not surprise patients with out-of-network care bills, instead requiring healthcare providers and insurers to broker price compromises between themselves. The No Surprises Act, enacted on a bipartisan basis in December 2020, protects patients from surprise billing from…
The ACR Seeks Trainees for AMA/Specialty Society RUC & CPT Committees
Advisors of the American Medical Association (AMA) Current Procedural Terminology (CPT) and Relative Value Update (RUC) Committees play a crucial role in the code creation and valuation process. These positions allow the ACR to have a significant voice in influencing changes and ensuring rheumatology services are effectively represented.
Get Expert Advice on Compliance Safeguards Post-Pandemic
Payer audits and coding scrutiny are in full swing after an influx of fraudulent claims during the COVID-19 pandemic. Make sure your coding practices are in compliance to protect your revenue.
Key 2022 Coding & Billing Updates
In 2022, rheumatology practices should prepare for documentation, coding, billing and reimbursement revisions related to evaluation and management (E/M), split/shared billing policies and telehealth services.
Defining Administration Complexity by the Drug, Not the Diagnosis
Enabling rheumatology practices to use complex administration codes for biologic drugs is critical for maintaining patient access to essential therapies.
New Healthcare Price Transparency Requirements Are Complicated & Vary by State
Healthcare law is ever changing, particularly with regard to price transparency. Key healthcare leaders and stakeholders have long argued for more stringent price transparency regulations in an effort to increase patient awareness regarding the cost of a hospital item or service prior to receiving the service. Such information is anticipated to enable patients to take…
The ACR Thanks Members for Participating in the Relative Value Update Process
Participation in the American Medical Association Relative Value Update Committee surveys contributes to the accurate valuation of rheumatology services.
The Relative Value Update Process: Your Input Makes a Difference
Selected ACR members will be invited to participate in a survey from the AMA Relative Value Update Committee. If you do, respond by the listed date. Data from these surveys helps set Medicare and other payer reimbursement rates.
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