In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices. Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…
Rheumatology Research Foundation Names Honorary Board of Advisors
The Rheumatology Research Foundation’s Honorary Board of Advisors is reserved exclusively for individuals who have made a transformative contribution, via a significant donation or through leadership, leaving an indelible mark on the organization’s future fundraising success. This year, Audrey M. Nelson, MD, from the Mayo Clinic, and ACR Executive Vice President Mark Andrejeski were named…
ACR & Emirates Society of Rheumatology Produce Education Conference
In September, the ACR participated in a global rheumatology event by partnering with the Emirates Society of Rheumatology (ESR) to jointly produce an educational meeting. The 4th Annual Conference of the Emirates Society of Rheumatology, in partnership with the ACR, took place Sept. 19–21 in Dubai Festival City, Dubai, United Arab Emirates (UAE). The conference…
Association of Rheumatology Professionals: New Name but the Commitment Remains the Same
Rheumatology is truly a people specialty: We often develop lifelong relationships with our patients as well as our colleagues. We increasingly recognize that providing the best rheumatologic care requires a team effort. The collegial nature of our specialty is reflected in the ACR’s mission statement: To empower rheumatology professionals to excel in their specialty. In…
Year in Review: The Impact of Advocacy & RheumPAC in 2018
In 2018, did you interact with the Medicare payment system, receive payment for a consultation code or worry about the Centers for Medicaid & Medicare Services (CMS) reducing reimbursement through its proposal to combine evaluation and management codes in the Physician Fee Schedule? If your answer to any of those questions is yes, then you…
2019 Changes to E/M Documentation
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Up to Date with the HIPAA Privacy Rule
Throughout a patient’s lifetime, providers are entrusted with their most intimate and personal information, which they expect to be kept private and confidential. Unfortunately, the healthcare system can face serious implications if any part of a patient’s privacy or information is breached. Under the Health Information Portability & Accountability Act (HIPAA) and state laws healthcare…
Coding Corner Answers: A Drug Administration Quiz
Take the challenge. C—This claim cannot be coded without querying the infusion nurse and physician. There must be documentation of the patient’s weight to document the correct dosage of the medication to be given to the patient. Also the start time and the completion time of the infusion must be documented to know which drug…
Coding Corner Questions: A Drug Administration Quiz
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
New ACR COIN Project Connects Volunteers to Patients in Greatest Need
Improving access to rheumatology care for underserved patient populations is a priority for the ACR, and the subject of a major position statement by the Committee on Rheumatologic Care (CORC) in 2017. According to the ACR’s 2015 Workforce Study, the existing shortage of rheumatologists and rheumatology health professionals is expected to worsen in the next…
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