Patient-centered care requires increased communication and a proactive patient. But how does it benefit a rheumatology practice? According to Stanford Shoor, MD, patient-centered care offers a team-based approach that can improve satisfaction in care and positively affect RA-specific outcomes…
The Why & What of the ACR’s Clinical Practice Guidelines
With the support of its membership, the ACR publishes clinical practice guidelines in multiple disease areas based on the best available clinical and scientific data. These aim to support health professionals treating rheumatology patients to give the best possible care. Like any set of medical guidelines, ACR guidelines are based on evidence of several different…
Tips for Surviving FDA Audits of Your Clinical Trials
SAN DIEGO—You come to work. The day is going well. Your clinical trials are moving along. Then you get the call: It’s the Federal Drug Administration (FDA), and they’re coming to audit in about a week. You might be struck by a sense of dread. But you don’t have to be, an expert said at…
Tools & Training from the ACR Practice Management Team
The ACR Practice Management Department actively works to provide valuable, accessible resources addressing practice issues on a local and national level to rheumatologists and their staff. Our trained professionals are devoted to providing the most up-to-date tools and resources to help improve practice efficiency while meeting the myriad compliance obligations of the ever-changing healthcare landscape….
Rheumatology Coding Corner Answer: Bilateral Knee Injections
Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a…
Rheumatology Coding Corner Question: Bilateral Knee Injections
A 68-year-old male patient returns to the office for his scheduled bilateral knee injections for primary osteoarthritis. The patient rates the pain in his right knee at an 8 on a scale of 10, and the pain in his left knee at a 7. He was in the office a week before, but the practice…
Health Plans Enact Coverage Policies for Remicade & Infliximab Biosimilars
Several major health plans have recently enacted policies regarding coverage status for Remicade (infliximab) and its biosimilars, Inflectra (infliximab-dyyb) and Renflexis (infliximab-abda). Most of these plans are limiting coverage for the biosimilar products to very specific circumstances. Some have also begun denying claims for biosimilars and instructing patients to switch to Remicade. The plans implementing…
How to Avoid Insurance Denials for Prescribing a Biologic Without MTX in Concert
The Insurance Subcommittee (ISC) of the ACR’s Committee on Rheumatologic Care (CORC) has recently received a number of reports from members regarding denials for biologics for patients not on methotrexate. To help avoid an often-lengthy appeals process, the ACR/ARHP recommends that members document a patient’s history of methotrexate intolerance or contraindication at every visit. What…
Submit MIPS Data to the CMS via RISE by March 2
If you have not done so already, you may submit your 2017 MIPS data to the Centers for Medicare and Medicaid Services (CMS) starting today. Log in to your RISE dashboard, click on all the MIPS categories you would like to report through RISE, and then click on the Submit button. The deadline to submit…
Rheumatologist Shortage Looms Amid Surging Patient Demand
(Reuters Health)—A growing number of patients are seeking care from rheumatologists for chronic health problems like arthritis, back pain and osteoporosis, just as the supply of specialists is shrinking, two new studies suggest. An estimated 6,013 clinicians in the U.S. specialized in rheumatology as of 2015, the equivalent of 5,415 full-time providers, according to one…
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