In early March, the Centers for Disease Control and Prevention (CDC) released a new report showing that the number of Americans living with arthritis is at an all-time high. According to the report, 54 million Americans now live with arthritis, and approximately 79 million will have arthritis by 2040. This stark picture comes at a…
CMS Notifying Clinicians of Their MIPS Status
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Administrative Contractors (MACs) that process Medicare Part B claims have begun informing providers of their participation status in the Merit-Based Incentive Payment System (MIPS). This information is coming in the form of hard-copy letters that started mailing in late April and will continue…
Rheumatology Coding Corner Question: Billing Infusion Procedure with JW Modifier
An 82-year-old female established patient diagnosed with ankylosing spondylitis in multiple joints returns to the office for her second infliximab infusion. She denies any fevers, cough or concurrent illness. Her joint pain is 7 on a scale of 1–10. She complains of achy pain in the cervical, lumbar and sacral regions of her spine. She…
Rheumatology Coding Corner Answer: Billing Infusion Procedure with JW Modifier
Take the challenge. CPT: 99214-25, 96413, 96375, 96361-59, J1745 x 4 J1745 JW* x 36, J1200 x1 ICD-10: M45.09, T50.995A, R06.02, E66.3, Z68.2 Rationale Modifier 25 is appropriate to use because it indicates the patient received a significant, separately identifiable E/M service on the same day as the infliximab infusion. This E/M service entailed the…
ACR Advocates for Regulatory Relief and Flexibility for MACRA
The American College of Rheumatology (ACR) continues to provide feedback to the Centers for Medicare & Medicaid Services (CMS) about the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 on behalf of rheumatologists. The bipartisan bill repealed the Sustainable Growth Rate and transitioned Medicare from fee for service to a system…
ACR Leaders to Talk Policy with Congressional Leaders in D.C.
On May 11, ACR leaders will fly to Capitol Hill to meet with Congressional leaders on behalf of ACR and ARHP members. With so many pressing policy issues facing the medical community this year, we hope that you, too, will let your members of Congress know where you stand on the following issues: Support Medical…
Use Time Component When Coding Counseling, Coordination of Care Visits
Although there are seven components for the levels of evaluation and management (E/M) services, most encounter levels are coded on the basis of the history, examination and medical decision making (MDM), which are the key components extracted from documentation in the medical record. However, when counseling and coordination of care for a patient are the…
Participate in Virtual Capitol Hill Meetings with the ACR
On May 11, ACR leadership representatives from the Board of Directors, the Affiliate Societies Council and the Committee on Government Affairs and RheumPAC will take the ACR’s policy messages to Capitol Hill for the Advocacy Leadership Conference. There is power in numbers, so we hope you will participate in our Virtual Hill Day by visiting…
Rheumatology Research Foundation Fundraising Campaign Exceeds $60M Goal
The Rheumatology Research Foundation’s largest fundraising campaign, Journey to Cure, has surpassed its $60 million fundraising, raising a grand total of $61,430,466. With the support of 3,869 donors, the campaign has funded awards for more than 900 rheumatology professionals. “The success of Journey to Cure demonstrates the commitment rheumatologists and health professionals have to impacting…
How to Be Heard: Tips for Efficient & Effective Advocacy
Did you know that there are more state legislators in this country than practicing rheumatologists? There are more than 7,300 state legislators alone, and each represents tens of thousands of constituents. As providers, you have a unique expertise that can be valuable to legislators in making decisions on biosimilars, research funding, insurance reform and a…
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