Video: Superheroes, Secret Identities & You| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Billing/Coding

Electronic Health Record Documentation Guidelines

  |  

The operations management team in healthcare practices is expected to have an effective coding compliance program in place that is continually evaluated and reevaluated. To accurately assess the program’s effectiveness, several outcome indicators must be measured, including error rates in the provider’s documentation and the electronic health record (EHR). Due to increased scrutiny by the…

Rheumatology Research Foundation Honors Award Recipients

  |  

SAN DIEGO—In November, the Rheumatology Research Foundation honored 155 award and scholarship recipients at the Awards Celebration, an annual luncheon, held in conjunction with the ACR/ARHP Annual Meeting. The event celebrates the accomplishments of rheumatology professionals who have received funding from the Foundation. In congratulating the award recipients, executive director Mary Wheatley, CAE, IOM, emphasized…

Update on ACR’s Rheumatology-Specific APM

  |  

Efforts by the ACR to develop a rheumatology-specific alternative payment model (APM) are well under way. The first draft proposal was approved by the ACR Board of Directors in November and presented to the rheumatology community during the 2017 ACR/ARHP Annual Meeting in San Diego. The ACR is pursuing the development of a rheumatology-specific APM…

Rheumatology Coding Corner Answers: 2017 End-of-Year Quiz

  |  

Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…

Rheumatology Coding Corner Questions: 2017 End-of-Year Quiz

  |  

1. A 68-year-old new female patient has an appointment to see the rheumatologist in four days. The patient has her medical records sent over from her primary care physician, neurologist and endocrinologist for the rheumatologist to review prior to the visit. Upon receipt, the rheumatologist spends 55 minutes reviewing the records and making notes. Can…

CMS Finalizes Changes in CY 2018 for Musculoskeletal Ultrasound

  |  

We previously alerted you to a CMS-proposed change that would cut reimbursement for the complete diagnostic musculoskeletal ultrasound (MSUS) significantly. We are pleased to report that, in its final rule, the CMS reversed that decision, and providers will see a reasonable reimbursement for the exam. The ACR advocated on your behalf for this change through…

ACR Works to Eliminate Part B Drug Costs from MIPS Payment Adjustments

  |  

The ACR is taking steps to clarify a proposed rule from the Centers for Medicare and Medicaid Services (CMS) that, as currently written, would consider the cost of Part B drugs when calculating physician reimbursement under the Merit-Based Incentive Payment System (MIPS). “The ACR is concerned about this, because large cuts to reimbursement for pass-through…

Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2

  |  

Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…