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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Rheumatology Coding Corner Answer: Follow-Up Knee Injection

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Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale CPT Codes: 20610-LT, J7325x16 ICD-10 Code: M17.12 This claim is rejected by the insurance carrier because the injection was outside of the preauthorization window that ended on Oct. 31. Most insurance carriers enforce their preauthorization dates for procedures. In…

Rheumatology Coding Corner Question: Follow-Up Knee Injection

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On Nov. 4, a 55-year-old female patient presents to the office for a follow-up visit for injection of the left knee for osteoarthritis. This is her third of three injections that were preauthorized through Oct. 31. She reports pain and swelling in her left knee and rates the pain at an 8 on a 10-point…

5 Steps to Help You Manage Prior Authorizations

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Despite continuous movement to streamline the prior authorization process, physician practices are still struggling with jumping through hoops to have procedures and medications covered. A prior authorization (PA) is the process insurance carriers have in place to approve or reject prescriptions based on plan formulary. The PA process is important in ensuring appropriate and cost-effective…

The ACR’s 2018 Legislative & Regulatory Priorities

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A recent Politico article outlined the looming agenda facing Congress as 2018 begins: Fund the government, raise the debt ceiling, modify spending caps, address healthcare subsidies, allocate additional funds for disaster relief, and address the status of millions of undocumented young immigrants.1 Amid all that activity, the ACR, through its Government Affairs Committee (GAC) and…

Rheumatology Research Foundation Welcomes New President, VP

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The Rheumatology Research Foundation has appointed Abby G. Abelson, MD, with the Cleveland Clinic to serve as president. She begins a two-year term alongside the new vice president, S. Louis Bridges Jr., MD, PhD, with the University of Alabama at Birmingham (UAB). Drs. Abelson and Bridges are highly accomplished leaders in the field of rheumatology…

In Memoriam: Paul A. Bacon, MD

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Paul A. Bacon, MD, professor emeritus of the University of Birmingham’s Department of Rheumatology, died on Jan. 5, 2018. The news of his passing saddened those who had the good fortune to know and collaborate with him. He was admired for his indefatigable dedication to measurement in rheumatic disease, especially vasculitis, as well as to…

Ethics Forum: What to Do When an Autoimmune Patient Needs a Transplant?

W. Blaine Lapin, MD, Jennifer L. Rammel, MD, MPH, & Andrea A. Ramirez, MD, MEd  |  

Despite our best efforts and modern interventions, we still have patients in the intensive care unit with organ failure. Although renal failure can be mitigated by dialysis, patients with cardiac or respiratory failure secondary to active autoimmune disease raise difficult clinical and ethical issues. Two recent cases, both with organ failure, led us to examine…

Joan M. Von Feldt, MD, MSEd: A Shopper with a Cause

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Joan M. Von Feldt, MD, MSEd, loves fashion—everything from the feel of natural fabrics and the fit of a well-crafted garment to mixing and matching colors and textures. As a professor of medicine at the University of Pennsylvania and editor in chief of the Journal of Clinical Rheumatology, she enjoys being well dressed and, like…

The Smartphone as Diagnostic Tool

Larry Beresford  |  

SAN DIEGO—Increasingly, technological advances are placing new tools into the hands of office-based rheumatologists. And they don’t have to cost a lot in capital equipment outlays by the medical group, because some of the best advances can be accessed via the device that is already in most doctors’ pockets, their smartphone. Smartphone technology gets more…