On July 3, the Rheumatology Research Foundation announced the names of 63 rheumatology trainees, educators, clinicians, investigators and health professionals who will receive Foundation-funded awards. In support of the Foundation’s mission to improve the health of people with rheumatic diseases, the awards help recruit and train the next generation of rheumatology professionals and advance research…
ACR Pushes for Patient Interests, Against Spending Cuts
Greetings from Washington, D.C. Your advocacy team had another busy month. Unlike my prior updates, and in order to keep our focus on health policy, I avoid mentioning anything about Washington investigations into obstruction of justice, collusion, etc. You get enough of that elsewhere. The Healthcare Bill Obamacare repeal and reform efforts are speeding up….
Why I Advocate for Rheumatology: Teaching the Basics
If you speak to any advocate for rheumatology, each of us has an “Aha! moment,” when we learned the importance of advocacy. My own came a dozen years ago. I was meeting with a legislative aide to a local congressman who was a senior member of the committee overseeing Medicare. He introduced himself as the…
Documentation Guidelines for Proper Medical Decision Making
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
Highlights from the Second Annual ACR Division Directors’ Conference
The second annual ACR Division Directors’ Conference took place in Chicago on March 10–11. The conference opened with a presentation on the use of the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry in academic medical centers by Salahuddin “Dino” Kazi, MD, from UT Southwestern Medical Center, and Jinoos Yazdany, MD, MPH, from the University of California…
Rheumatology Coding Corner Question: Infusion Services for Skilled Nursing Facility Patient
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
Rheumatology Research Foundation Funding Enables Potential Treatment Advancements
Investigators at Brigham and Women’s Hospital recently discovered a novel subset of peripheral helper T cells (TPH) that drive rheumatoid arthritis (RA) inflammation. Originally published in the February issue of Nature, findings from this study provided bedrock knowledge for developing new RA therapies. Now, with funding from the Rheumatology Research Foundation, investigators are expanding on…
A Look at CPT Codes for Prolonged Services
In the 2017 Medicare physician fee schedule, the CMS officially activated CPT codes 99358 and 99359 as reimbursable codes for non-face-to-face prolonged services performed in the office or outpatient setting, hospital or nursing facility by physicians or other qualified health practitioners (not clinical staff). The CPT codes are defined as 99358: Prolonged evaluation and management service…
NGS Updates E/M Coding Requirements for Examination Component
Effective for dates of service on and after July 1, 2017, the National Government Services (NGS), the Medicare administrative contractor for Jurisdictions 6 and K, will require providers in their region to adhere to new evaluation and management (E/M) services expectations for the expanded problem-focused and detailed CPT examination components. The new requirement adds specificity…
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