The Rheumatology Research Foundation’s strong financial health and commitment to accountability and transparency have earned yet another four-star rating from Charity Navigator, America’s largest independent charity evaluator. This is the 10th consecutive time the Foundation has earned this top distinction. Only 1% of charities have ever received 10 consecutive four-star evaluations, indicating the Foundation outperforms… [Read More]
A 60-year-old man returns for a follow-up related to his diagnoses of rheumatoid arthritis and chronic gout of his right ankle and foot, without tophi. He reports the gout flares have subsided in his ankle. He takes 450 mg of allopurinol daily. He has rheumatoid factor-positive rheumatoid arthritis, which previously affected multiple sites, without organ… [Read More]
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 CPT: 99213 ICD-10: M1a.0710, M05.79 History—The history of present illness was extended. The review of systems was extended, and two past family social history elements were documented. This makes the history level detailed. Examination—Five systems were examined. This makes the exam level detailed. Medical decision… [Read More]
Don’t forget: The submission window for the Quality Payment Program Performance Year 2018 closes on Tuesday, April 2, 2019. Submissions must be complete by 8:00 PM EDT. We encourage all MIPS-eligible clinicians to double-check their status and final scores with the CMS by logging into their EIDM account. Not sure how to review your final score?… [Read More]
UnitedHealthcare (UHC) announced in the March issue of its Provider Network Bulletin that it will discontinue payment for consultation codes (CPT 99241–99255) later this year. Implementation of the policy will occur in two phases. On June 1, 2019, UHC will eliminate the consultation codes for practices with contracted rates based on a stated year 2010 or… [Read More]
In the next few weeks, you may be selected to participate in an AMA/Specialty Society RVS Update Committee (RUC) survey for physician office visits (99202-99205, 99211-99215) and a new prolonged services code (99XXX). As you may know, the components of the Medicare Physician Payment Schedule are physician work, practice expense and professional liability insurance. This… [Read More]
The 2019–2020 legislative cycle in the states holds real hope and opportunity for critical reforms to protect rheumatology practices and patients. It is important to note that because of the state legislative process, bill passage almost always comes later in the legislative session. Although the rheumatology community has not yet seen many official wins, early… [Read More]
Join us for the Rheumatology Documentation and Coding Workshop taking place during the 2019 State-of-the-Art Clinical Symposium, Friday, April 5 in Chicago. The Rheumatology Documentation and Coding Workshop will take a deep dive into the new Medicare coding and documentation requirements for evaluation and management coding, medical decision making and specificity in diagnosis coding. Due… [Read More]
Did you know a laboratory can perform one of two different tests when a provider orders an HLA-B27 blood test? The ACR Insurance Subcommittee has received several complaints regarding commercial payer coverage for these tests, depending on which methodology the lab employs. To avoid administrative burden, members should familiarize themselves with lab practices and payer… [Read More]
Take the challenge. 1. A—Modifier -25 is defined as a significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure or other service. It is to be placed on the E/M visit only because it attests to the payer there is… [Read More]