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Subcategories:Billing/CodingEMRsFacilityInsuranceQuality Assurance/ImprovementTechnologyWorkforce

Principles Would Streamline Prior Authorization Processes

Carol Patton  |  

The ACR recently partnered with the American Medical Association (AMA) and a coalition of 16 other organizations representing physicians, medical groups, hospitals, pharmacists and patients to dramatically reshape prior-authorization protocols. The coalition is urging an industry-wide reassessment of these protocols to align with a newly created set of 21 principles, called the Prior Authorization and…

Rheumatology Coding Corner Answer: Coding for a Knee Injection

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CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral primary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in the patient’s medical chart….

Why Keep a Seat at the AMA Table?

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As 2017 unfolds—a year when MACRA begins, lawmakers take steps to dismantle the health reform efforts of the past eight years, and political uncertainty is the rule—it is imperative that the ACR leverage its advocacy agenda by maintaining its seat at the American Medical Association’s (AMA’s) House of Delegates (HOD), says Gary Bryant, MD, FACP…

Electronic Medical Records Have Mixed Impact on Quality, Quantity of Healthcare

David S. Knapp, MD, FACR  |  

The widespread implementation of electronic medical records (EMRs) and electronic health records (EHRs) has significantly changed the quality and quantity of healthcare for both the better and the worse. The digitalization of medical records provides comprehensive documentation of all events and actions associated with an individual’s medical care. Likewise, legibility, accountability and credibility are greatly…

The ACR Insurance Subcommittee Advocates for Fair Payer Policies

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The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…

Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes

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Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…

2015 ACR/ARHP Workforce Study of Rheumatology Specialists Predicts Future Workforce Shortfall

Sharad Lakhanpal, MBBS, MD  |  

Ten years have elapsed since the ACR conducted its last workforce study, and we know that much has changed. The comprehensive patient-centered, integrative approach to the 2015 ACR/ARHP Workforce Study of Rheumatology Specialists in the United States (now publicly available) describes the character and composition of the current clinical workforce, recognizes demographic and employment trends,…