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…
Hospital for Special Surgery Focuses on Measuring, Adding Value
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
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…
Self-Auditing Important for Rheumatology Practices
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…
Rheumatology Coding Corner Question: Billing for Trigger Point Injection, Office Visit
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….
Rheumatology Coding Corner Answer: Billing for Trigger Point Injection, Office Visit
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…
Rheumatology Patients Are Essential to the ACR’s Grassroots Advocacy
Over the past several years, the ACR has collectively ramped up its advocacy efforts. Under the leadership of the Government Affairs Committee and with the combined advocacy efforts of many ACR/ARHP members and their patients, we made considerable progress advancing priority issues in 2015. With the ongoing effort of ACR members and patients, we can…
Opinion: Rheumatologists Cautioned Against Wasteful Testing to Find Rare Diseases
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…
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