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

From the College

Rheumatology Coding Corner Answer: RA Follow-Up with Imaging

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Take the challenge. CPT codes: 99214, 71045, 86580 ICD-10: M05.79, R05, R06.2 History—Detailed: The history of present illness (HPI) was extended; the review of systems (ROS) was extended; and the past medical, family and social history (PFSH) were documented. All three components of the HPI, ROS and PFSH are needed to achieve the detailed history…

Rheumatology Coding Corner Question: RA Follow-Up with Imaging

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History A 39-year-old woman returns for follow-up for her rheumatoid arthritis. She has positive rheumatoid factor, but no organ or systemic involvement. She has joint swelling and pain in her left hand, right elbow and right knee. Her pain is at an 8 on a 10-point scale. She states the pain is worse in the…

Medicare Participation—Do Physicians Have Options?

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Physicians have three contractual options when it comes to the Medicare program: participating, non-participating and opting out. Providers should keep the old saying “look before you leap” at the forefront when considering opting in or out of the Medicare program. Since 2001, physician costs have been on the rise, with only mini­mal increases in reimbursements,…

Rheumatology Research Foundation & NIH Program Bears Fruit

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The Rheumatology Research Foundation has been actively involved with the NIH’s Accelerating Medicines Partnership for Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE) program, launched in 2014 as a public–private partnership to spur development of new therapeutic options for RA and lupus. Recently, the NIH released new datasets that will help clinical investigators accelerate therapies…

ACR Named a Top Atlanta Workplace for 2nd Consecutive Year

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In a designation based on employee opinion, the ACR has been named one of the top places to work in Atlanta for the second year in a row. The honor is “a testament to the supportive and enthusiastic environment that we foster,” says ACR Executive Vice President Mark Andrejeski…

Prior Authorizations Hurt Patients & Practices

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The ACR was part of a 16-member collaboration that created a set of 21 principles on prior authorization and utilization management, intended to ensure that patients receive timely and medically necessary care and medications and reduce the administrative burdens. More than 100 other healthcare organizations support those principles. Now, the AMA has released the results…

Write Your Letter to the Editor: The ACR Makes It Easy

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Elected officials and government entities make decisions every day that directly affect your practice and ability to treat patients. Although the ACR continues to be your eyes and ears in Washington, D.C., often the most effective agents of change are citizens, like you, who get involved in the legislative process. It’s easy to be an…

Rheumatology Coding Corner Answer: Follow-Up Knee Injection

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Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale CPT Codes: 20610-LT, J7325x16 ICD-10 Code: M17.12 This claim is rejected by the insurance carrier because the injection was outside of the preauthorization window that ended on Oct. 31. Most insurance carriers enforce their preauthorization dates for procedures. In…

Rheumatology Coding Corner Question: Follow-Up Knee Injection

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On Nov. 4, a 55-year-old female patient presents to the office for a follow-up visit for injection of the left knee for osteoarthritis. This is her third of three injections that were preauthorized through Oct. 31. She reports pain and swelling in her left knee and rates the pain at an 8 on a 10-point…