Eight years ago, the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs embarked on a comprehensive review of the AMA Code of Medical Ethics. What emerged after years of hard effort, intensive feedback and thoughtful revisions was a modernized version of the guide, which the AMA House of Delegates voted to adopt in…
Cyber Safety in the HIPAA Age
Ready for a cyber checkup? Auditing your health IT policies, safeguarding your hardware and educating your staff on the importance of data security should be routine, according to industry experts…
Top ACR Priorities in 2017 Include Drug Costs, MACRA
With a new federal administration and Republican-controlled Congress taking the helm in 2017, the ACR Government Affairs Committee has identified top legislative and regulatory priorities for the year. “The main priority is going to be helping represent the rheumatology community as Medicare is reformed, because the era of MACRA started Jan. 1,” says Angus Worthing,…
Insurance Subcommittee to the Rescue
Concerned about reimbursement for specialty drugs? Wondering if your patient can continue on a prescribed medication despite formulary changes? Unsure how to request a tier exception? No need to face these issues alone. The ACR has a resource that can assist with questions regarding coverage and payment policies for private insurers and Medicare. That resource…
MACRA: More Points, Smarter Future
As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…
2015 ACR Workforce Study Report Offers Rheumatologists Chance to Improve Patient Care, Financial Outlook
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
Self-Driven Care Can be Difficult for Adolescents Transitioning from Pediatric to Adult Rheumatology Provider
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
Rheumatology Coding Corner Year-End Quiz Answers
Take the challenge. D—As of January 2015, there are three new codes added to the arthrocentesis codes of 20600–20611. The new codes, 20604, 20606 and 20611, should be reported when the procedure is performed with ultrasound guidance and CPT 76942 should not be billed separately. The three new codes are defined as: 20604—Arthrocentesis, aspiration and/or…
New Physician Payment Reforms Highlight Need for Quality Coding, Accurate Documentation
To be an effective practice owner, it is necessary to understand the financial circumstances and environment of the practice’s operation. Well-managed practices prevent the loss of time and money. Therefore, to improve productivity and operating efficiencies, you need to have a basic understanding of billing and payment initiatives that will impact the practice’s bottom line….
Rheumatology Coding Corner Year-End Quiz Questions
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
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