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…
UHC Updates Policy on Reimbursement for Incident-to Services
On Aug. 1, UnitedHealthcare implemented a new policy on Services Incident-to a Supervising Health Care Provider that allows for appropriate reimbursement for “incident-to” services consistent with current Medicare guidelines.
Bipartisan DXA Bill Under Consideration in Congress
The Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act would set a $98 floor for Medicare reimbursement for the dual-energy X-ray absorptiometry (DXA) bone density test.
Coding & Reimbursement Guidelines for Interprofessional Consultation Codes
Current Procedural Terminology (CPT) codes 99446–99449 were created in 2014 to capture the time spent by a consultant who is not in direct contact with the patient at the time of service. An interprofessional telephone/internet consultation (ITC) is defined as an assessment and management service in which a patient’s treating provider (e.g., primary or qualified…
Relative Value Survey Forthcoming for Updated AMA Outpatient Consultation Codes
Some ACR members will be randomly selected to take an important survey to determine relative values for services in new outpatient consultation codes.
Medicare Contractors Provide Guidance for Use of JA, JB Modifiers
As of April 2021, Medicare requires the use of the JA or JB modifier when billing for drugs that have one Healthcare Common Procedure Coding System Level II (J or Q) code but multiple routes of administration.
10 Tips to Master E/M Coding Changes
Learn to properly use the revised CPT codes to document your time and medical decision making during patient visits to help ensure your practice is appropriately remunerated.
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