Many rheumatologists chose the profession because they wanted to delve more deeply into rheumatic diseases than internal medicine calls for. “For most, this level of specialization is sufficient and worthy of a lifelong devotion and commitment,” says S. Sam Lim, MD, MPH, associate professor, Medicine and Epidemiology, Emory University School of Medicine, Atlanta. “However, some…
Hospital for Special Surgery Focuses on Measuring, Adding Value
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
How Villain Deaths in James Bond Movies Would Be Coded under ICD-10
Similar to other healthcare professionals, I have been required to use ICD-10 codes for the past several months. Unfortunately, I have been unable to discern any improvement in my patient care, but perhaps I have not used the codes long enough. Certainly, healthcare administrators and statisticians assure me there are several advantages of ICD-10 over…
Opinion: Role of Rheumatology Nurse Should Be Expanded
The care of patients with rheumatic diseases has undergone a great transition, with high expectations for both patients and healthcare professionals to achieve quality outcomes for the many different disorders. Integral to this goal is the development of new care models, with evolving roles for the various care providers on the multidisciplinary team.1-3 A new…
Self-Auditing Important for Rheumatology Practices
In its 2016 Work Plan, the HHS Office of Inspector General (OIG) outlined its plans for audits and evaluations of covered entities to work on creating a permanent and more structured audit program. In light of their focused effort, the Office for Civil Rights has indicated that they will concentrate on areas of high risk…
Rheumatology Coding Corner Question: Billing for Trigger Point Injection, Office Visit
A 35-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left and right shoulders and her neck. The pain is considerably worse in the morning. She denies any fever, cough or dyspnea. The physician performs a problem-focused exam….
Rheumatology Coding Corner Answer: Billing for Trigger Point Injection, Office Visit
Take the challenge. Correct Coding: 99213-25, 20552 Diagnosis: M79.70 There continues to be a lot of confusion on proper coding for trigger-point injections. Two CPT4 codes can be used: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Injection(s); single or multiple trigger point(s), three or more muscle(s). The CPT4 codes are based…
Opinion: Rheumatologists Cautioned Against Wasteful Testing to Find Rare Diseases
What rheumatologist doesn’t love the good old zebra hunt? You know—the pursuit of diagnosing the extraordinarily rare disease purely through pluck and wits. The zebra hunt is almost a tradition, a perennial topic of polite, but subtly boastful, conversation among peers and the subject of numerous career-building case reports. The hunt also happens to be…
Health Apps Often Lack Privacy Policies & Share Our Data
(Reuters Health)—Just because a health app has a privacy policy doesn’t mean the data will remain private, an analysis of mobile tools for diabetes suggests. In fact, privacy policies appear rare, and when they do exist, most state that user data will be collected and half warn that medical information will be shared with third…
Doctor Quality Ratings May Be Influenced By Setting
(Reuters Health)—Patients give the same doctors different ratings depending on where their visit took place, according to a small U.S. study. Although doctors might act differently in an emergency department compared with a calmer office setting, researchers say the results also suggest that ratings are not a completely reliable measure of the quality of care…
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