The word rheumatology and its counterpart, rheumatologist, are new to the English language. They didn’t exist 50 years ago. There were a relatively few physicians interested in rheumatologic disease, but not the science of rheumatology. The American College of Rheumatology was founded in 1988. A few of us still alive, notably, the centenarian Ephraim Engelman,…
What started out as a way to bring specialty medicine to rural areas around 40 years ago has evolved from sharing imaging and laboratory results to seeing and interacting with patients remotely. Telemedicine is beginning to evolve from its traditional urban–rural linkage, and rheumatologists are following along. “Telemedicine covers a variety of services, but it…
Dramatic changes have occurred over the past 50 years in rheumatology practice and management. As an integral part of the healthcare team, the rheumatology nurse must navigate these changes and the advancements in treatment options and care available for patients with rheumatic disease. Rheumatology nursing was recognized as a nursing specialty by the American Nurses…
As a physician, it’s important to be in the present 100% of the time. “Writing the wrong number on a prescription pad is an extreme, but important, example of what could happen if a physician is distracted,” says consultant Donna Singer, Donna Singer Consulting LLC, Newton, Mass. Sanjay Chabra, DO, director of rheumatology, St. Jude…
In today’s busy rheumatology practices, the services of nurse practitioners, physician assistants, occupational therapists and clinical nurse specialists are a great asset for patient flow, as well as increased revenue. As the growth of nonphysician providers (NPPs) in rheumatology practices has evolved, it has become increasingly important to understand the incident-to rules and avoid the…
Incident-to Billing Case Scenario A 51-year-old female patient returns for a follow-up visit with a physician assistant (PA) for unilateral primary osteoarthritis of her right knee. She had an intraarticular corticosteroid injection of her right knee six weeks prior to her visit. She reports significant improvement in her knee pain and stiffness, and states the…
Diagnoses: ICD-9 715.16, 528.02, E943.8 ICD-10 M17.11, K12.32, T39.395A This was an established patient visit with a new diagnosis. Because the PA sought out the physician to address the new problem and document the assessment and treatment, the visit can still be billed as incident-to. Note: The physician initiated the plan of care for treatment…
Large-scale health data breaches reported by doctors and health plans have been rising steadily, a new report shows. From 2010 to 2013, nearly 1000 large breaches affected more than 29 million individual health records, and more than half resulted from theft or loss of laptops, thumb drives and paper records, according to researchers with access…
Ethical considerations for rheumatologists in terminating consultative services to a community hospital
Tips to establish collaborative patient care models with your PAs, NPs