NEW YORK (Reuters Health)—Children’s electronic health records (EHRs) are missing functions “essential” for managing children’s health, according to a multistakeholder work group that produced a “high-priority” list of EHR requirements. “Most doctors caring for children in hospitals or office practices now use EHRs, which benefit children and families by offering decision-support and other safety features…
Participate in CMS Reporting Study to Receive 2018 Improvement Activity Credit
The Centers for Medicare & Medicaid Services (CMS) is conducting the 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the Quality Payment Program Year 2 final rule (CMS 5522- FC). The CMS is conducting this study to: Examine clinical workflows and data-collection methods using different submission systems; Understand the challenges clinicians face when…
Anthem Cancels Planned Modifier 25 Cuts
Anthem, a Blue Cross Blue Shield company that operates in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia and Wisconsin, has decided not to move forward with a policy that would have resulted in decreased reimbursement for evaluation and management (E/M) services when billed with modifier 25. As reported…
Is Patient-Centered Care Effective for Rheumatology?
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…
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