Payer audits and coding scrutiny are in full swing after an influx of fraudulent claims during the COVID-19 pandemic. Make sure your coding practices are in compliance to protect your revenue.
Key 2022 Coding & Billing Updates
In 2022, rheumatology practices should prepare for documentation, coding, billing and reimbursement revisions related to evaluation and management (E/M), split/shared billing policies and telehealth services.
Defining Administration Complexity by the Drug, Not the Diagnosis
Enabling rheumatology practices to use complex administration codes for biologic drugs is critical for maintaining patient access to essential therapies.
New Healthcare Price Transparency Requirements Are Complicated & Vary by State
Healthcare law is ever changing, particularly with regard to price transparency. Key healthcare leaders and stakeholders have long argued for more stringent price transparency regulations in an effort to increase patient awareness regarding the cost of a hospital item or service prior to receiving the service. Such information is anticipated to enable patients to take…
The ACR Thanks Members for Participating in the Relative Value Update Process
Participation in the American Medical Association Relative Value Update Committee surveys contributes to the accurate valuation of rheumatology services.
The Relative Value Update Process: Your Input Makes a Difference
Selected ACR members will be invited to participate in a survey from the AMA Relative Value Update Committee. If you do, respond by the listed date. Data from these surveys helps set Medicare and other payer reimbursement rates.
Fiscal Year 2022 ICD-10-CM Codes Now in Effect
New and updated FY22 diagnosis codes became effective for encounters on or after Oct. 1, 2021, including key updates for Sjögren syndrome and non-radiographic axial spondyloarthritis.
ACR Practice Experts Can Answer Challenging Business Questions
Coding questions and billing compliance are just a few of the issues ACR practice management specialists can help managers and rheumatologists navigate to recoup reimbursement and ensure timely patient treatment.
The ACR Responds to CVS Caremark Prior Authorization Changes
The ACR sent a letter to CVS Caremark detailing how recent updates to its prior authorization forms for many biologic drugs are increasing the paperwork burden for rheumatology practices and hurting patients’ timely access to treatment.
Coding Corner: Interprofessional Telephone/Internet/Electronic Health Record Assessment & Management
Example 1 A cardiologist contacts a rheumatologist concerning a lupus patient. The rheumatologist sees the patient four weeks later for a complete examination. A 20-minute call is initiated to review the findings and the patient’s chart with the cardiologist. After the call is completed, the rheumatologist completes a verbal and written report to the patient’s…
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