The ACR has compiled guidelines and tips on how to use the JW modifier and correctly bill Medicare for discarded drugs and biologicals. This modifier can be applied only to unused amounts from a single-dose vial or package.
New HCPCS Code Added for Anifrolumab-fnia, 1 mg
Effective for dates of service on or after April 1, the Healthcare Common Procedure Coding System (HCPCS) code J0491 is valid for billing 1 mg anifrolumab-fnia.
Key 2022 Coding & Billing Updates
In 2022, rheumatology practices should prepare for documentation, coding, billing and reimbursement revisions related to evaluation and management (E/M), split/shared billing policies and telehealth services.
ACR Practice Experts Can Answer Challenging Business Questions
Coding questions and billing compliance are just a few of the issues ACR practice management specialists can help managers and rheumatologists navigate to recoup reimbursement and ensure timely patient treatment.
Coding & Reimbursement Guidelines for Interprofessional Consultation Codes
Current Procedural Terminology (CPT) codes 99446–99449 were created in 2014 to capture the time spent by a consultant who is not in direct contact with the patient at the time of service. An interprofessional telephone/internet consultation (ITC) is defined as an assessment and management service in which a patient’s treating provider (e.g., primary or qualified…
10 Tips to Master E/M Coding Changes
Learn to properly use the revised CPT codes to document your time and medical decision making during patient visits to help ensure your practice is appropriately remunerated.
Proposed 2020 E/M Codes Include Reimbursement Changes
Increased reimbursement would reflect value of cognitive care and other time-intensive services provided by rheumatologists.
CMS Proposes Major Payment Increases for E/M Services
CMS estimates that under their proposal, released July 29, rheumatologists would see on average a 15% payment increase, beginning in 2021.
Coding Corner Answers: A Drug Administration Quiz
Take the challenge. C—This claim cannot be coded without querying the infusion nurse and physician. There must be documentation of the patient’s weight to document the correct dosage of the medication to be given to the patient. Also the start time and the completion time of the infusion must be documented to know which drug…
Coding Corner Questions: A Drug Administration Quiz
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
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