The American Medical Association’s (AMA) RVS Update Committee (RUC) and the Current Procedural Terminology Committee (CPT) meet six times per year to review resource costs and code descriptors for provider services. At these meetings, the ACR is represented by several volunteers and staff to provide a voice in shaping Medicare policy for rheumatology. The first…
Articles by From the College
ACR Advocates Against Proposed UHC Policy Changes
UnitedHealthcare (UHC) recently proposed two policy changes that would have a negative impact on reimbursement for consultation services and evaluation and management (E/M) services when billed with modifier 25. The effective date for both of these proposed changes is Oct. 1, 2018. Consultation Services Under the proposed consultation codes policy, UHC would end reimbursement for…
RISE Continues to Improve Offerings for Providers
ACR members are realizing what they have at their fingertips—a registry fully staffed with knowledgeable people ready to help them succeed under MIPS. This valuable resource allows members to do what they do best: Treat patients with rheumatoid arthritis (RA), which is one of the primary goals of the Rheumatology Informatics System for Effectiveness (RISE)…
RheumPAC Members Speak Out on the Importance of Political Action Committees
People can support causes, committees, campaigns, etc. in infinite ways. Members of the ACR/ARHP can see their efforts magnified via an investment in the ACR’s political action committee, RheumPAC. Your contribution goes directly to help support rheumatology and rheumatologists around the country. Proof of any group’s success can be seen in the satisfaction of its…
Join Us for an Advanced Rheumatology Coding & Practice Management Summit in Chicago
Before the ACR/ARHP Annual Meeting gets started in Chicago in October, the ACR’s pre-meeting practice management and coding courses offer an intensive educational opportunity. The Oct. 19–20 sessions, ACR Coding Course: Unlock the Mysteries of Advanced Coding for Rheumatology and Practice Management: Putting the Pieces Together—Winning Strategies for Rheumatology Practices, are the industry’s premier events…
Understanding & Preparing for Payer Audits
Audit activity among Medicare and most third-party payers has increased in response to pressure to reduce healthcare costs. The return of billions of dollars to Medicare, Medicaid and third-party programs through these medical audit reviews has also increased. For example, the Government Accountability Office (GAO) 2014 Annual Report estimated that the Centers for Medicare &…
ACR/ARHP Advocacy Leaders Lobby U.S. Congress
On May 16 and 17, ACR/ARHP leaders serving on the Board of Directors, Affiliate Society Council, Government Affairs Committee, Committee on Rheumatologic Care, RheumPAC Committee and Insurance Subcommittee once again went to Capitol Hill to advocate on behalf of ACR/ARHP members and their patients. The group represented 27 states and the District of Columbia, and…
It’s Time to Register for the 2018 ACR/ARHP Annual Meeting
Attended by over 15,000 rheumatology professionals from over 100 countries, the ACR/ARHP Annual Meeting is the largest rheumatology meeting in the world and the premier educational event for physicians, health professionals and scientists who treat or research rheumatic and musculoskeletal diseases. The 2018 Annual Meeting will be held Oct. 19–24 in Chicago. Attendees will be…
Foundation-Funded Researchers Study Pneumonia Risk, Doc Shortages, Decision Making
In the coming fiscal year (July 1, 2018–June 30, 2019), the Rheumatology Research Foundation has committed to fund more than $9.4 million in rheumatology research and training. Approximately half of the awards will support efforts to recruit and train the next generation of rheumatology professionals. The remaining funds will be awarded to advance research projects…
Rheumatology Coding Corner Answer: Medical Chart Review of an Infliximab Infusion
Take the challenge. CPT codes: 96413, 96415, 96375, J1745x30, J1200x1 Diagnosis ICD-10: M05.79 With the total infusion time of two hours and 13 minutes, CPT code 96413 is used to code for the first hour of the infusion and 96415 for the additional hour. The infusion would have to be 31 minutes into the next…
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