The Centers for Medicare & Medicaid Services (CMS) released the final rule for the Quality Payment Program (QPP) year 3 (CY 2019) on Nov. 1, 2018. Below, we have compiled a list of key changes to ensure MIPS-eligible clinicians are accurately reporting for CY 2019: New MIPS-eligible clinician types: Physical therapist, occupational therapist, qualified speech-language… [Read More]
Articles by From the College
Final 2019 Physician Reimbursement Rule Released by CMS Includes Victories for Rheumatology
On Nov. 1, after months of advocacy efforts spearheaded by the ACR and others, the Centers for Medicare and Medicaid Services (CMS) released the CY 2019 Medicare physician fee schedule rule, and it included several victories for rheumatology. Upon initial review, it appears the CMS has taken into account the concerns expressed by the ACR and… [Read More]
2018 MIPS Reporting via RISE: Are You Ready?
It’s time to prepare for 2018 MIPS reporting via the Rheumatology Informatics System for Effectiveness (RISE) registry, and the ACR is here to help. To ensure you’re ready to submit your data to the CMS, RISE users should take the following steps: Complete the survey to notify the ACR of your intent to report via… [Read More]
RheumPAC Champions Recognized
Election Day 2018 has come and gone, and a new class of legislators will be joining the ranks of Congress in January. RheumPAC is the most important tool we have to establish relationships with our new legislators and this year, our ACR volunteer leaders stepped up and matched all donations to RheumPAC leading up to… [Read More]
CMS Proposes New Part B Drug Payment Model
Late last month, the Centers for Medicare & Medicaid Services (CMS) released an advance notice of proposed rulemaking (ANPRM), seeking feedback on a potential drug pricing model called the International Pricing Index (IPI) model. This comment solicitation is in alignment with the administration’s blueprint to lower drug costs and reduce out-of-pocket costs, and is an… [Read More]
UnitedHealthcare Retires Fax Numbers Used for Prior Authorization Requests
Unfortunately, prior authorization continues to be a burden for providers, practices, and patients. Effective Jan. 1, 2019, UnitedHealthcare (UHC) will retire fax numbers used for medical prior authorization (PA) requests. After this date, UHC will require PA requests to be submitted through their Prior Authorization and Notification tool. Providers who can’t submit requests electronically may… [Read More]
Improve Your Claim Submissions Process
Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as… [Read More]
Fighting Lupus Among Latinas
Systemic lupus erythematosus (SLE) is more prevalent among Hispanic women than white women, according to two recent studies published in Arthritis & Rheumatology.1,2 However, Latinas often lack awareness of lupus, which can contribute to delays in diagnosis and treatment, and lead to worse outcomes. “One of the challenges is reaching out to the Latino community,… [Read More]
Coding Corner Answer: Rheumatology Coding & Practice Quiz
Take the challenge. B or D—If it was not documented, it was not done is the motto of many coders. For those who follow this motto, the answer would be B. But there is another option for the coder and that is to query the physician about whether the injection was done with ultrasound guidance… [Read More]
Coding Corner Question: Rheumatology Coding & Practice Quiz
1. A 45-year-old female patient with a diagnosis of primary osteoarthritis returns to the office for her second scheduled injection of sodium hyaluronate (Supartz). The nurse takes the patient’s vitals: weight is 185 lbs., height is 5’2”, and temperature is 98.2°F. The patient is prepped and given the injection. How should this encounter be coded?… [Read More]
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