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Articles by From the College

Rheumatology Coding Corner Answer: Coding & Billing Basics

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Take the challenge. 1. D: All of the above Rationale: Per CPT, if time spent counseling and/or coordinating care dominates the session, then total time must be documented; greater than 50% of the time must be for face-to-face counseling and/or coordinating care, and must be documented as such. Additionally, the extent of the counseling and/or…

The ACR, ARHP Develop National Research Agenda for 2016–2020

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Since 2005, the ACR’s Committee on Research has been responsible for advancing the research goals of the organization and providing leadership in research and research training in rheumatology via the ACR’s Research Agenda. The ACR Research Agenda is designed to address critical areas of research in rheumatic diseases, including the need for new technology, new…

How to Decipher the American Medical Association’s Billing, Coding Processes

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The American Medical Association consists of two key groups: 1) the Relative Value Scale Update Committee (RUC), which oversees the annual updates to the physician work relative values, and 2) the Current Procedural Terminology (CPT) Editorial Panel, which assigns new or revised codes in the CPT book. The CPT Process Current Procedural Terminology (CPT) was…

Self-Auditing Important for Rheumatology Practices

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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 Answer: Billing for Trigger Point Injection, Office Visit

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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…

The ACR Announces Research Agenda for 2016–2020

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Future rheumatology-specific research should focus on the definition of new therapeutic targets, improving the understanding of existing therapies, engaging patients in their care and more, according to a recent assessment by the ACR’s Committee on Research…