A 55-year-old female patient returns for her second infliximab infusion. Her temperature is 98°F, her height is 5’6″ and her weight is 151 lbs. She received 210 mg infliximab via infusion. The patient arrived at the clinic at 8:15 a.m. and left at 10:55 a.m. Can this encounter be coded correctly? Yes No A 38-year-old…
Rheumatology Coding Corner Answer: Documentation Improvement
Take the challenge. B—No. Although the documentation states the patient arrived at the clinic at 8:15 a.m. and left the clinic at 10:55 a.m., it does not document the actual start and stop times of the infusion. According to CPT, when reporting codes for which infusion time is a factor, use the actual time over…
Preparing for Increased HIPAA Audits Among Smaller Rheumatology Providers
Recent enforcement activities of the Department of Health and Human Services’ Office for Civil Rights (OCR) have shown an increase in fines and penalties assessed against smaller providers for failing to comply with the privacy, security and breach notification requirements of the Health Insurance Portability and Accountability Act (HIPAA). Historically, OCR has focused on larger…
Role of Dietitians in Rheumatology
What do dietitians do to help manage patients with rheumatic disease? Dietitians are well integrated, for example, in the practice of nephrology and diabetes, but few are active in the specialty of rheumatology. However, dietitians are recognized as part of the team of providers designated to care for patients with rheumatic disease by the ACR….
Rheumatology Research Foundation Launches #RheumLife
May is recognized as National Arthritis Awareness Month, a time to bring attention to the more than 46 million Americans living with arthritis and related inflammatory diseases. In honor of the occasion, the Rheumatology Research Foundation is launching #RheumLife, a social media campaign to bring awareness to the severity of rheumatic disease. Through Twitter and…
Addressing the Rheumatology Workforce Shortage
In 2008, the American College of Rheumatology Workforce Study Advisory Group published a comprehensive rheumatology workforce analysis.1 It concluded: Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include…
Study Associates Higher Risks with Total Joint Arthroplasty among Patients with Hepatitis C
A study that looked at the impact of hepatitis C on short-term outcomes of total joint arthroplasty found an increase in co-morbidity compared with patients without the liver disease. The number of people in need of total joint arthroplasty is expected to rise in conjunction with an aging population and advances in hepatitis C treatments….
Rheumatologist Shares Lessons Learned in 20 Years as Program Director
When I came to Washington University School of Medicine (WUSM) in St. Louis in 1996 to become fellowship program director, the previous program director had left, and the two fellows who had been selected both backed out (this was before the match). I was handed a stack of manila folders, which contained the previous documentation….
Opinion: Adhering to Standards of Care Helps Manage Risk
Medicare and other third-party payers have started predicating reimbursement on adherence to standards of care. Post hoc chart reviews have resulted in substantial take-backs for failure to adhere to those values in cardiology, pulmonology and expanding to other areas. Outpatient medicine is also being subjected to such scrutiny. The question of standards and who sets…
Phase 2 of HIPAA Audit Program Launches
With many competing priorities facing physician practices, HIPAA compliance and security is not a topic that usually makes it to the top of the list. But this is not the case with the Department of Health and Human Services’ Office for Civil Rights (OCR), because it has initiated a new phase of audits of physician…
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