In its 2016 Work Plan, the HHS Office of Inspector General (OIG) outlined its plans for audits and evaluations of covered entities to work on creating a permanent and more structured audit program. In light of their focused effort, the Office for Civil Rights has indicated that they will concentrate on areas of high risk…
A 35-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left and right shoulders and her neck. The pain is considerably worse in the morning. She denies any fever, cough or dyspnea. The physician performs a problem-focused exam….
Take the challenge. Correct Coding: 99213-25, 20552 Diagnosis: M79.70 There continues to be a lot of confusion on proper coding for trigger-point injections. Two CPT4 codes can be used: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Injection(s); single or multiple trigger point(s), three or more muscle(s). The CPT4 codes are based…
What rheumatologist doesn’t love the good old zebra hunt? You know—the pursuit of diagnosing the extraordinarily rare disease purely through pluck and wits. The zebra hunt is almost a tradition, a perennial topic of polite, but subtly boastful, conversation among peers and the subject of numerous career-building case reports. The hunt also happens to be…
It is valuable to understand the semantics of consultant comments. A journal article I once read indicated that when a consultant reports having seen a series of individuals with a given problem, it means they have seen two cases. When they report they have experience with a problem, they mean they have seen a (one)…
In busy rheumatology practices, mountains of paperwork for insurance companies and federal healthcare programs make it hard to keep track of what’s legal. Missing documentation is the most common way to spark an investigation. Here are a few considerations to help you avoid legal pitfalls…
Rheumatologists practicing in rural and urban areas face different challenges. Robert Jackson, DO, discusses how technology, healthcare reform and hospital closures affect rheumatology practice in rural areas and its future…
Starting your own rheumatology practice is daunting, and it’s easy to focus on the medical side and neglect the business side of a practice. Here are five important considerations that could help a new practice thrive…
Take the challenge. M10.072—Acute gout has an Excludes 1 note of chronic gout (M1A.-). This means that acute gout and chronic gout cannot be coded for the same encounter, as the codes are mutually exclusive. M45.6—The patient is diagnosed with ankylosing spondylitis of the lumbar region. M81.8—Other osteoporosis without current pathological fracture. M79.622—The patient has…
I am honored, humbled and excited to serve as your ACR president. I’d like to share the following background information to illustrate the diverse set of life experiences I draw from to represent the ACR membership effectively. Personal Background Thanks to my mom, who was born and raised in Guatemala, I am bilingual in Spanish…