On Feb. 16, ACR leaders, insurers, pharmaceutical representatives, patients, patient advocacy representatives and more met in Scottsdale, Ariz. They came together for the first annual RISE Summit, aimed at setting strategic priorities and goals for the Rheumatology Informatics System for Effectiveness (RISE) Registry, the qualified clinical data registry developed by the ACR. The Rise of…
The ACR Is Exploring a Rheumatology-Specific APM
In response to the required changes in reimbursement from fee for service to value-based payment under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, the ACR is exploring development of a rheumatology-specific alternative payment model (APM) for rheumatologists and practices, which would provide an additional option for payment other than the Merit-Based Incentive…
How to Appropriately Discharge a Patient to Avoid Abandonment, Medical Malpractice
Are you a physician with a patient who no longer requires medical treatment? Do you have a patient you believe would be better served by another physician, specialist or practice due to a developing condition? Do you want to terminate a patient relationship because it is costing more than it is worth to your practice?…
Ultrasound Can be Useful in Diagnosing Gout
The presence of synovial monosodium urate monohydrate (MSU) crystals is the gold standard for diagnosing gout. But a new study, funded in part by the ACR and led by rheumatologists, including Alexis Ogdie, MD, MSCE, evaluated the effectiveness of ultrasound in diagnosing it. The study found that ultrasound can be useful in discriminating gout from non-gout….
Rheumatologists Concerned High Healthcare Costs May Encourage Patients to Forgo, Delay Treatment
While members of Congress debate healthcare legislation, rheumatologists say many of their patients struggle to afford everything from generic drugs to insurance copayments for physical therapy. “It’s a mess. The cost of prescriptions and the rationale for those rising costs in the U.S. right now—it’s just a mess,” says James R. O’Dell, MD, Stokes-Shackleford Professor of…
Prospects for Treating Patients with Arthritis in African Countries with Few Rheumatologists
At present, the U.S. has approximately 5,000 full-time adult rheumatologists. By the year 2025, that number will decline to roughly 3,600.1 Sounds dire, right? Hold that thought. Question: What country has 99 million people and no adult rheumatologists? Answer: Ethiopia.2 The Nigerian Story And then there is Africa’s most populous country, Nigeria, with roughly 170…
Tips to Help Physicians Understand, Cope, Manage Burnout
Years ago, the Mayo Clinic was exploring effective ways to minimize burnout among the more than 3,000 doctors employed at its three medical and research facilities in Rochester, Minn., Scottsdale, Ariz., and Jacksonville, Fla. One strategy involved inviting physicians to participate in small groups to discuss topics that were fairly ubiquitous among doctors, from medical…
Advantages, Disadvantages of Private Practice Ownership for Rheumatologists
When he worked for a multi-specialty practice, Jonathan M. Greer, MD, FACR, FACP, president, Arthritis and Rheumatology Associates of Palm Beach, and affiliate clinical professor of medicine, Nova Southeastern University, Boynton Beach, Fla., found that there were too many restrictions and controls and no way to enhance the revenue stream for rheumatologists. So he moved on…
Documentation Guidelines for Proper Medical Decision Making
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
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