Accurate reimbursement for rheumatology services ensures rheumatologists can run successful practices and provide needed care, but only if they speak up through survey input to explain how much that care costs. Here’s how to participate in the process when rheumatology CPT codes come up for review.
Although the Centers for Medicare & Medicaid Services (CMS) is simplifying documentation through its Patients over Paperwork initiative, clinical documentation improvement (CDI) did not go away. CDI is not about how to code in ICD-10-CM or the Current Procedural Terminology (CPT); instead, it is a huge part of the solution in maximizing the integrity of…
The evaluation and management (E/M) code set in the American Medical Association’s Current Procedural Terminology (CPT) book lists descriptors, as well as typical times for patient visits. These times are averages of how long it takes a physician to complete all components of a visit at each level. Because the specific times identified in the…
A 60-year-old man returns for a follow-up related to his diagnoses of rheumatoid arthritis and chronic gout of his right ankle and foot, without tophi. He reports the gout flares have subsided in his ankle. He takes 450 mg of allopurinol daily. He has rheumatoid factor-positive rheumatoid arthritis, which previously affected multiple sites, without organ…
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 CPT: 99213 ICD-10: M1a.0710, M05.79 History—The history of present illness was extended. The review of systems was extended, and two past family social history elements were documented. This makes the history level detailed. Examination—Five systems were examined. This makes the exam level detailed. Medical decision…
UnitedHealthcare (UHC) recently proposed two policy changes that would have a negative impact on reimbursement for consultation services and evaluation and management (E/M) services when billed with modifier 25. The effective date for both of these proposed changes is Oct. 1, 2018. Consultation Services Under the proposed consultation codes policy, UHC would end reimbursement for…