Cigna recently announced that they will discontinue payment for consultation codes later this year. As of Oct. 19, 2019, the payer will implement a new policy on Evaluation and Management (R30) that will deny claims billed with CPT codes for consultation services as not valid. Impacted CPT codes are 99241, 99242, 99243, 99244, 99245, 99251,…
Sign Up for RISE to Report for MIPS in 2019
Join RISE by Aug. 31 to be ready for 2019 MIPS reporting. The MIPS payment adjustment increases to plus or minus 7 percent this year, so it’s never been more important to make sure you are ready to report your best performance. RISE staff are here to assist you with the submission process so you…
Coding Corner Answer: Interprofessional Consultations
Take the challenge. Answer: This is a two-part office visit scenario. The first part of the scenario illustrates the original new patient office visit, and the second portion is for the follow-up, interprofessional telephone consultation with the patient’s ophthalmologist. For the office visit … CPT: 99203 ICD-10: B30.8, M45.5, I73.00 The history was detailed, because…
Coding Corner Question: Interprofessional Consultations
A 68-year-old patient reports that her eyes have been itchy and red for approximately one month. She was treated with erythromycin gel on Jan. 10; while the itching did not stop, the redness resolved. She denies any matting and has not used any other type of eye drops. She states there has been no change…
4 Steps to Prevent Unnecessary Claims Denials
Denied claims represent unpaid services, or lost or delayed revenue. Avoiding claims denials is the responsibility of everyone in a practice. Any deficiency on a focused strategy for denials management will have unfavorable resolutions to denials or lead to writing off the service without payment. With the changing landscape in practice management, the best route…
The Training Rheum Helps Practices Quickly Onboard NPs & PAs
Has your practice recently hired a nurse practitioner (NP) or physician’s assistant (PA) to help provide care to a growing patient population? Are you considering hiring, but unsure if you have the time or resources to adequately train someone new to the specialty? The Training Rheum is designed to give your professional staff a solid…
Expert Says Vaccines Are Largely Safe for Rheumatology Patients
CHICAGO—Rheumatologists often come to Brian Schwartz, MD, associate professor of medicine and vice chief for clinical affairs in the Division of Infectious Diseases, University of California, San Francisco, with a concern: A patient on immunosuppression has a family member who needs a live vaccine, but the patient may be vulnerable to the vaccine’s effects. Should…
How Rheumatologists Can Better Partner with Social Workers
When Liz Morasso, LCSW, facilitates a Families Living with Rheumatic Diseases support group at Children’s Hospital Los Angeles, she empathizes with the struggles and challenges of her young patients. Ms. Morasso was only 16 years old when she was diagnosed with both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). She knows all too well…
Study Shows Lupus Clinics Outperform General Rheumatology Clinics
Are outcomes better in a specialized lupus clinic compared with care provided in a general rheumatology setting? New research from Rush University, Chicago, studies this important care management question and finds the specialized clinic does indeed produce better outcomes.1 A big part of the difference may be due to the added experience specialty clinic clinicians…
What Attracts Us to Rheumatology? A Veteran Rheumatologist Reflects
What attracts physicians to a career in rheumatology? Traditionally, the foundation of clinical training at both the medical student and house staff level is based on inpatient services. There are many reasons for this, predominantly revolving around access to patients available for teaching. The result: Trainees are predominantly exposed to a group of conditions that…
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