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?…
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,…
Rheumatology Coding Corner Question: Infusion Services for Skilled Nursing Facility Patient
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
Tight RA Control Via Telemedicine Noninferior to Conventional Clinic Visits
NEW YORK (Reuters Health—Telemedicine follow up based on patient-reported outcome (PRO) is noninferior to conventional outpatient care for tight control of disease activity in rheumatoid arthritis (RA) patients with low disease activity or remission, new findings show. “Even though patients in the [telemedicine] follow-up groups requested more acute visits, they over-all had a more than…
A Look at CPT Codes for Prolonged Services
In the 2017 Medicare physician fee schedule, the CMS officially activated CPT codes 99358 and 99359 as reimbursable codes for non-face-to-face prolonged services performed in the office or outpatient setting, hospital or nursing facility by physicians or other qualified health practitioners (not clinical staff). The CPT codes are defined as 99358: Prolonged evaluation and management service…
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