Take the challenge. 1. D: All of the above Rationale: Per CPT, if time spent counseling and/or coordinating care dominates the session, then total time must be documented; greater than 50% of the time must be for face-to-face counseling and/or coordinating care, and must be documented as such. Additionally, the extent of the counseling and/or…
How to Decipher the American Medical Association’s Billing, Coding Processes
The American Medical Association consists of two key groups: 1) the Relative Value Scale Update Committee (RUC), which oversees the annual updates to the physician work relative values, and 2) the Current Procedural Terminology (CPT) Editorial Panel, which assigns new or revised codes in the CPT book. The CPT Process Current Procedural Terminology (CPT) was…
Opinion: Politics Should Not Trump Science in Medicine
I tell my patients there are three types of science: 1) investigative science, which sometimes gets it right; 2) science in the courtroom, which is junk science; and 3) science in Washington, D.C., which is political science. Our decisions are based on art and science; our patients’ medications are brought to market based on science….
Tips for Selecting Best Job Candidates to Fill Positions, Avoid Turnover
As much as 80% of employee turnover can be attributed to bad hiring decisions, the Harvard Business Review reported.1 And turnover costs are high—one report estimated them to be 100–300% of the base salary of a replaced employee (with 150% commonly cited).2 Given this, the importance of hiring the right employees can’t be underestimated. So…
2015 ACR/ARHP Annual Meeting: Better Pain Prevention, Treatment Needed for Older Adults
SAN FRANCISCO—A broadening of the medical community’s horizons in how pain is regarded and treated in older adults, including those with osteoarthritis and other rheumatic diseases, is sorely needed, a researcher said at the 2015 ACR/ARHP Annual Meeting. Incidence Studies show that a large percentage of older adults each year see physicians for such issues…
What Rheumatologists Need to Know about Payer Audits
Both government and private payers continue to aggressively monitor providers to prevent and recover overpayments. This is evidenced by the fact that the number of audits conducted in recent years has increased dramatically. A negative audit finding can result in the need to repay five- or seven-figure amounts. Types of Audits Private Payer Audits Private…
How Rural Rheumatologists Are Coping with Passage of Affordable Care Act, Changes in Reimbursement, Payment Systems
Four years ago, a series of articles in The Rheumatologist talked about the practice of rheumatology in rural settings. Since then, changes have occurred, with the passage of the Affordable Care Act (ACA), differences in reimbursement and the trek toward value-based payment systems. One major concern expressed in the original article was the fact that…
How Rheumatologists Can Find, Develop Their Specialty Niche
Many rheumatologists chose the profession because they wanted to delve more deeply into rheumatic diseases than internal medicine calls for. “For most, this level of specialization is sufficient and worthy of a lifelong devotion and commitment,” says S. Sam Lim, MD, MPH, associate professor, Medicine and Epidemiology, Emory University School of Medicine, Atlanta. “However, some…
How Villain Deaths in James Bond Movies Would Be Coded under ICD-10
Similar to other healthcare professionals, I have been required to use ICD-10 codes for the past several months. Unfortunately, I have been unable to discern any improvement in my patient care, but perhaps I have not used the codes long enough. Certainly, healthcare administrators and statisticians assure me there are several advantages of ICD-10 over…
Opinion: Role of Rheumatology Nurse Should Be Expanded
The care of patients with rheumatic diseases has undergone a great transition, with high expectations for both patients and healthcare professionals to achieve quality outcomes for the many different disorders. Integral to this goal is the development of new care models, with evolving roles for the various care providers on the multidisciplinary team.1-3 A new…
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