In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
Ongoing Advocacy Efforts Seek Use of Complex Administration Codes for Biologics
Ongoing ACR advocacy efforts are working to keep biologic drugs accessible to rheumatology patients, defending the ability of rheumatology practices to use the complex chemotherapy codes for administration of biologic therapies.
American Medical Association House of Delegates Meets In-Person; ACR Successfully Advances New Policies
The ACR’s resolution addressing inappropriate Medicare Administrative Contractor policy processes was adopted, and two co-led resolutions on ARPA-H funding and saline shortages also passed the policy-making body.
Defining Administration Complexity by the Drug, Not the Diagnosis
Enabling rheumatology practices to use complex administration codes for biologic drugs is critical for maintaining patient access to essential therapies.
Analysis of National & Local Coverage Determinations
The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….
Coding Corner Answers: Rheumatology Word Search
Take the challenge. Ultrasound guidance: There must be a permanent picture placed in the patient’s medical chart to meet the requirements of documentation guidelines. Arthrocentesis: This is the proper term for the withdrawal of fluid and/or injection of medication into a joint. If both the aspiration and injection are performed during the same encounter, only…
Coding Corner Questions: Rheumatology Word Search
Find the words/terms suggested by the following clues: What is the procedure conducted when a permanent picture is required for a joint injection? What is another name for a joint injection? What should be done when a patient returns for an infusion and a prior authorization has already been approved? On what body system is…
ACR Supports Bill for Increased Medicare Contractor Transparency
Working with more than 40 other medical associations, the ACR is supporting proposed federal legislation, the Local Coverage Determination Clarification Act of 2017 (S. 794). The bill is co-sponsored by Sens. Johnny Isakson (R-Ga.), Tom Carper (D-Del.), John Boozman (R-Ark.) and Debbie Stabenow (D-Mich.). The bill’s provisions would add transparency to how Medicare Administrative Contractors…
CMS Notifying Clinicians of Their MIPS Status
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Administrative Contractors (MACs) that process Medicare Part B claims have begun informing providers of their participation status in the Merit-Based Incentive Payment System (MIPS). This information is coming in the form of hard-copy letters that started mailing in late April and will continue…