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…
Articles by From the College
Rheumatology Research Foundation-Funded Study Shows Promise for New RA Treatments
Joseph Holoshitz, MD, and his laboratory have made significant advances in understanding a genetic risk factor of rheumatoid arthritis (RA). This knowledge has grown into discoveries that could lead to new RA treatments in just a few years. “There was a critical point in time when we had a big idea, but funding was a…
The ACR Announces Research Agenda for 2016–2020
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…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…
Federal Compliance Mandates for Medical Practices
Approximately 10 years ago, the Office of Inspector General (OIG) issued its first guidance on compliance as it relates to federal mandates for physician practices. Although taking the necessary steps can be a daunting task in an era of complex rules and heightened regulations, there are key areas of government-mandated compliance requirements that practices should…
Medicare Drug Coverage Plans for Rheumatologic Medications
Different parts of Medicare cover different services. For outpatient prescription drugs, Medicare has two distinct programs with a maze of complex policies. Most physicians along with Medicare patients, retail pharmacies, Medicare drug plans as well as Medicare Advantage health plans continuously struggle with navigating Medicare drug coverage under Part B and Part D. There are…
The ACR’s Current Healthcare Policy Priorities
The ACR advocates on behalf of rheumatologists, rheumatology health professionals and the rheumatology community through involvement in federal and state legislation and regulatory action, participation in hearings and education of lawmakers on issues important to rheumatologists, health professionals and patients. Through robust federal and state advocacy programs, the ACR engages lawmakers and informs them of…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
What is the ICD-10 guideline to code for osteoporosis without a current pathological fracture? There is no rule. Code for the osteoporosis, and code for the pathological fracture. Code for the osteoporosis from the M81._ category, and code for the history of a pathological fracture. None of the above is correct. How many characters are…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…
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