The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…
Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…
2015 ACR/ARHP Workforce Study of Rheumatology Specialists Predicts Future Workforce Shortfall
Ten years have elapsed since the ACR conducted its last workforce study, and we know that much has changed. The comprehensive patient-centered, integrative approach to the 2015 ACR/ARHP Workforce Study of Rheumatology Specialists in the United States (now publicly available) describes the character and composition of the current clinical workforce, recognizes demographic and employment trends,…
Clinicians May Have Inaccurate Views of Benefits, Harms of Treatments & Tests
NEW YORK (Reuters Health)—Clinicians’ expectations of the benefits and harms of a wide range of treatments and tests are rarely accurate, according to a new study. “There was variation—with benefits and harms sometimes being overestimated and sometimes being underestimated; but there was a tendency for clinicians to more often underestimate (rather than overestimate) harms and…
Chart a New Course: A Rheumatologist Talks about Practicing in an Orthopedic Environment
Working as a rheumatologist in an orthopedic practice has its own unique challenges, but may result in better patient care, according to Sheeja Francis, MD…
The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance
Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…
Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
How Hospital Design Can Promote Better Patient Outcomes
A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…
Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
2015 ACR Workforce Study Report Offers Rheumatologists Chance to Improve Patient Care, Financial Outlook
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
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