Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….

Rheumatology Informatics System for Effectiveness (RISE) Registry Can Help Rheumatologists Meet MACRA Requirements
The ACR has been at the forefront of helping rheumatologists meet practice demands, including federal reporting requirements. The first registry that helped meet these requirements was the Rheumatology Clinical Registry (RCR), and it facilitated quality reporting, but required manual entry of required data. More recently, ACR has contracted with FIGmd to create a tool that…
E-Health, Telemedicine Pose Challenges, Offer Benefits for Patients with Arthritis
(Reuters Health)—As more and more sick patients are going online and using social media to search for answers about their health, it’s raising a lot of thorny ethical questions for doctors. “The internet and ready access to vast amounts of information are now permanent aspects of how we live our lives, including how we think…

How to Leverage Patient Satisfaction
Medicare and other insurers are using patient satisfaction to determine provider payment. But according to one expert, rheumatologists who look at their practice with a critical eye, listen and ask their patients the right questions may improve their patient relationships and their practice…
How Sick Is Your Patient? Document the Details!
Clear. Complete. Concise. These three Cs describe ideal patient record keeping, which is why they are among the key reasons to implement a clinical documentation information (CDI) program into your rheumatology practice. Not only will CDI help you accurately document the full picture of each patient’s clinical status, but it also promotes high-quality care and…
Proposed CMS Physician Fee Schedule May Offer Slight Increases
All eyes are on the new physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS), which will be finalized this year and go into effect Jan. 1. The ACR is reviewing the proposal and will be providing comments and recommendations to CMS. And many rheumatologists have payment and coding questions: Will…
Healthy Clones: Dolly the Sheep’s Heirs Reach Ripe Old Age
LONDON (Reuters)—The heirs of Dolly the sheep are enjoying a healthy old age, proving cloned animals can live normal lives and offering reassurance to scientists hoping to use cloned cells in medicine. Dolly, cloning’s poster child, was born in Scotland in 1996. She died prematurely in 2003, at age 6, after developing osteoarthritis and a…

Nanomedicines May Reset the Immune System to Treat Disease
New research examines how nanomedicines may be able to reprogram disease-causing white blood cells, a process that may reset the immune system to a healthy state and enable targeted treatments for many autoimmune diseases…

Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…
Rheumatology Coding Corner Answer: Physical Examination with Infliximab Infusion
Take the challenge. CPT: 99214-25, 96413, 96415 x 1, J1745 x 35 ICD-10: M07.68, K51.80 Billing Overview It is appropriate to bill for an E/M visit for this day of service along with the infusion procedure. Modifier 25 should be appended to the E/M, indicating that the patient received a significant, separately identifiable E/M service…
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