Find the words/terms suggested by the following clues: What is the procedure conducted when a permanent picture is required for a joint injection? What is another name for a joint injection? What should be done when a patient returns for an infusion and a prior authorization has already been approved? On what body system is…
In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices. Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…
CHICAGO—Rheumatology physicians and researchers from Africa said the field’s resources and medical literature on the continent are slowly expanding, but they repeatedly lamented that the millions who suffer from rheumatic diseases there have major obstacles to overcome to access care. Their reviews and assessments—sometimes grim and sometimes hopeful—came in a session that was a joint…
CHICAGO—Approximately 200,000 health apps are available through major app stores. Some offer real benefits, said Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai Health System, Los Angeles, Calif. But most, he told attendees at the 2018 ACR/ARHP Annual Meeting, are “rubbish.” “They do one or two things only—and generally not well,” he…
CHICAGO—ACR leaders described a series of looming legislative and regulatory threats to rheumatologists and their patients—including the proposed collapsing of evaluation and management (E/M) coding and potential changes to step therapy rules—and urged everyone in the field to make their voices heard to quash the proposals. They also recounted recent victories in the policy realm…
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Take the challenge. C—This claim cannot be coded without querying the infusion nurse and physician. There must be documentation of the patient’s weight to document the correct dosage of the medication to be given to the patient. Also the start time and the completion time of the infusion must be documented to know which drug…
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
Missed appointments have long been a problem for rheumatology practices. A recent poll from the Medical Group Management Association (MGMA) found no-shows were the single biggest challenge reported by practice leaders, with 44% of respondents citing the issue.1 If a patient does not come to the office when scheduled, it starts a cascade of events…
NEW YORK (Reuters Health)—The proposed collapsing of payment amounts for levels 2 to 5 evaluation and management (E/M) services by the U.S. Centers for Medicare and Medicaid Services (CMS) would have different financial impacts on different specialties, researchers report. “Specialists that tend to have more complicated and/or longer visits would lose money, and specialists that…