On May 16, ACR and ARP leaders serving on the Board of Directors, Affiliate Society Council, Government Affairs Committee, Committee on Rheumatologic Care, RheumPAC and Insurance Subcommittee will go to Capitol Hill to advocate on behalf of the College’s membership and our patients. The group represents 31 states and the District of Columbia, and will…
Coding Corner Question: How to Bill a Rituximab Infusion Visit?
A 66-year-old female patient returns for a second infusion of rituximab for her diagnosis of rheumatoid arthritis in multiple sites. She is rheumatoid factor positive. She says the pain in her knees, elbows and neck has slightly improved. She rates the severity of her pain at a 7 on a 10-point scale, which is an…
Coding Corner Answer: How to Bill a Rituximab Infusion Visit?
Take the challenge. CPT Codes: 96413, 96415 x 3, J9312 x 5, 96375, J2920 Diagnoses: M05.79 Coding Rationale As of Jan. 1, 2019, the Healthcare Common Procedure Coding System (HCPCS) code for rituximab was changed from J9310 rituximab 100 mg, to the new HCPCS code J9312 (injection, rituximab, 100 mg). According to a Verywell Health…
Time Plays an Important Role in Selecting the Best Services Billing Code
The evaluation and management (E/M) code set in the American Medical Association’s Current Procedural Terminology (CPT) book lists descriptors, as well as typical times for patient visits. These times are averages of how long it takes a physician to complete all components of a visit at each level. Because the specific times identified in the…
New Research Foundation Award Supports the Future of Rheumatology
The workforce shortage in rheumatology is a critical issue the Rheumatology Research Foundation is tackling. The number of patients with rheumatic disease is growing exponentially, and that means more health professionals and innovative approaches are needed to ensure rheumatology practices are set up to offer the best care. In 2018, the ARP released a core…
Experts Offer Management Tips, from Contracts to Credentials to Audits
CHICAGO—Medical practice consultant Owen Dahl, MBA, LFACHE, CHBC, looked out at the rheumatology practice managers and physicians, sitting around tables with white tablecloths, and asked what seemed like a simple question: “How many of you have a strategic plan?” he asked. A single hand was raised. “One? How do you know where to go tomorrow…
The RISE Registry Delivers Practice-Based Evidence to Rheumatologists
The advent of quality-based healthcare, such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), requires rheumatology professionals to demonstrate their practice is based on interventions supported by the best available evidence and that their practice, in turn, provides quality care. These requirements have increased the need for methods to measure and quantify…
Value for Service: ACR Update on RUC & CPT Activities
The American Medical Association (AMA) Relative Value Update Committee (RUC) and Current Procedural Terminology (CPT) meet three times a year to keep the CPT code set up to date and review resource costs for physicians. The two-step meetings of the CPT Editorial Panel and the RUC allow physicians to provide direct input to the Centers…
In It Together: Peer-Support Programs Help Physicians After Stressful Events
A formal peer-support program for medical providers affected by stress and trauma is gradually becoming a cultural norm for rheumatologists and other physicians at Johns Hopkins University…
Closed Case? ACR Fights CMS Proposed Changes for E/M Reimbursement
When the Centers for Medicare and Medicaid Services (CMS) proposed coding and documentation changes to consolidate evaluation and management (E/M) services last fall, the ACR was among many specialist societies actively involved in advocating against the proposed ruling. The changes to E/M coding were part of a larger initiative to reduce the documentation burden on…
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