The ACR is engaging with payers regarding formulary requirements that would leave practices underwater when treating patients with rheumatic diseases.
Implementation of the G2211 add-on code for evaluation and management services is included in the CY 2024 Medicare Physician Fee Schedule, barring further delays. Ask your lawmakers to support timely implementation and patient access to complex care.
After significant pushback from the AMA, ACR and other medical societies, Cigna has delayed implementation of changes to its modifier 25 reimbursement policy, originally scheduled to take effect May 25.
The ACR has compiled guidelines and tips on how to use the JW modifier and correctly bill Medicare for discarded drugs and biologicals. This modifier can be applied only to unused amounts from a single-dose vial or package.
On Sept. 13, the ACR and Kevin D. Deane, MD, PhD, presented a proposal to create a new clinical code to recognize a condition in which an individual may exhibit rheumatoid arthritis-related autoantibodies without clinical presentation.
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
It’s 11 a.m. on a Wednesday. You see a new patient in your fellow’s clinic with impressive physical findings, including a prominent skin rash and deforming arthritis. The patient has been to many doctors and is frustrated that her condition remains undiagnosed and untreated. You thoroughly examine the patient, present her case to your attending…
Cigna will not move forward with changes to their reimbursement policy for evaluation and management (E/M) codes submitted with modifier 25 as originally scheduled.
Effective for dates of service on or after April 1, the Healthcare Common Procedure Coding System (HCPCS) code J0491 is valid for billing 1 mg anifrolumab-fnia.
This month, we offer an overview of the federal No Surprises Act, which stipulates that healthcare insurers may not surprise patients with out-of-network care bills, instead requiring healthcare providers and insurers to broker price compromises between themselves. The No Surprises Act, enacted on a bipartisan basis in December 2020, protects patients from surprise billing from…