Take the challenge. Scenario 1—A: The nurse practitioner may act as the supervising physician if it’s within the scope of practice for the NP and should be coded as follows: CPT: 96413, 96415, J1745 x 30, J1200 x 1 Diagnosis ICD:10: M05.79 Scenario 2—A: To qualify as an incident-to service, the PA can provide the…
Coding Corner Questions: Using NP/PA Services in Practice
Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…
Don’t Miss 2020 E/M Coding Workshop in New Orleans
Access to good training and education on practice management and coding issues has proved beneficial to physician success. Getting up-to-date information on compliance, insurance reimbursement, office efficiency, coding and billing is crucial for effective and efficient practice management. The ACR’s Committee on Rheumatologic Care (CORC) has created the premier one-day E/M Documentation Trends and Best…
Coverage & Reimbursement Challenges: Updates from the ACR Insurance Subcommittee Chair
The ACR Insurance Subcommittee is working to address specialty pharmacy requirements for in-office treatments, elimination of consultation codes and other coverage and reimbursement challenges.
Evaluation & Management Code Changes Set for 2021
Major changes to office and outpatient evaluation and management codes 99201–99205 and 99211–99215 will take effect Jan. 1, 2021.
Coding Corner Answers: Rheumatology Word Search
Take the challenge. Answers Biosimilars Methotrexate Time Presenting problem Ultrasound guidance International Classification of Diseases Current Procedural Terminology Trigger points Osteoporosis Osteoarthritis
Coding Corner Questions: Rheumatology Word Search
Questions What type of drug is interchangeable with an FDA-approved biologic? What drug is used in conjunction with infliximab, unless the patient cannot tolerate it? What can be used as a key element in an evaluation and management (E/M) service, along with the history, exam and medical decision making? What drives the level of an…
2019 MIPS Reporting via RISE: Are You Ready?
It’s time to prepare for 2019 MIPS reporting via the Rheumatology Informatics System for Effectiveness (RISE) registry, and the ACR is here to help. To ensure you’re ready to submit your data to the Centers for Medicare & Medicaid Services (CMS), RISE users should take the following steps: Review your data in the dashboard; Make…
Reimbursement Options for Services Without Direct Patient Contact
Beginning in October 2019, two major commercial payers, UnitedHealthcare and Cigna, discontinued payment for consultation services. The CPT codes affected include 99241–99245 and 99251–99255. The payers have instructed providers to instead bill the non-consultative evaluation and management (E/M) codes that best describe the services performed. If the non-face-to-face service goes beyond the usual time a…
Coding Corner Answers: Navigating Medicare’s Online Resources
Take the challenge. 1. A—Internet-only manuals Before appealing the request for an overpayment or appealing a denial, providers and staff should first verify the claim was coded and billed correctly. Second, staff should review the internet-only manuals website, which includes operating instructions, policies and procedures that cover CMS policies based on statutes, regulations, guidelines, models…
- « Previous Page
- 1
- …
- 4
- 5
- 6
- 7
- 8
- …
- 54
- Next Page »