New ICD-10-CM code R76.81 can now be used for patients who have abnormal rheumatoid arthritis (RA)-related autoantibodies—but not RA—to improve early disease risk identification, preventive care and research.
The ACR offers a variety of coding-focused Lunch-and-Learn sessions designed to help physicians and their staff stay current with evolving healthcare regulations, coding updates and billing practices.
Last week, the Centers for Medicare & Medicaid Services (CMS) announced that it is implementing a new prior authorization model called the Wasteful and Inappropriate Services Reduction (WISeR) Model. This six-year model, starting on Jan. 1, 2026, aims to reduce fraud, waste and abuse in traditional Medicare by using technology-enabled processes for prior authorization and…
As of Jan. 1, rheumatology practices face significant changes in coding and reimbursement for telemedicine services, including new and deleted billing codes, updated Medicare policies and looming expiration of pandemic-related flexibilities.
The 2025 Medicare Physician Fee Schedule final rule, released Nov. 1, includes a conversion factor of $32.3465, a 2.83% drop from 2024. In response to advocacy efforts from the ACR and other medical societies, Congress recently introduced the Medicare Patient Access and Practice Stabilization Act of 2024, which would eliminate the 2.83% payment cut and provide an inflationary update for 2025 equal to 50% of the Medicare Economic Index.
The Underwater Biosimilars Coalition shared with the Centers for Medicare & Medicaid Services concerns about problems arising from the average sales price payment methodology and discussed potential options for addressing these challenges.
The newest ICD-10 code set went into effect on Oct. 1 and includes more than 400 new and revised diagnosis codes and headers. In September, the ACR also proposed a new diagnosis code that will undergo a public comment period and consideration for inclusion in a future update.