Do you perform synovial fluid crystal examinations using polarized light microscopy? Synovial fluid crystal analysis is not on the list of provider-performed microscopy procedures (PPMP) approved by the Centers for Medicare & Medicaid Services (CMS).
The ACR’s Committee on Rheumatologic Care (CORC) is considering whether the ACR should seek CMS approval to allow performance and billing for synovial fluid crystal analysis as a PPMP and is seeking input from ACR members. Please answer a few questions that will help influence ACR priorities: https://forms.office.com/r/MDZhdQRLq0.
More Information
For rheumatologists, synovial fluid crystal analysis is a vital procedure to diagnose gout and pseudogout. However, federal regulatory agencies (the CMS and the Food & Drug Administration) have not granted permission for rheumatologists and other clinicians outside the laboratory to perform any form of synovial fluid microscopy, including crystal analysis. The ACR sought a change in these rules several years ago, but was not successful.
The ACR is considering another attempt to make synovial fluid crystal analysis, including use of polarized light microscopy, an approved PPMP. However, such approval would come with the potential for more cost and regulatory oversight. CORC is collecting information from ACR members to help evaluate this issue.
Additional information on the topic is available in a PowerPoint presentation for personal review or sharing with colleagues: Considerations for Rheumatologists & ACR: Rheumatologists Performing Synovial Fluid Crystal Analysis.
