LOS ANGELES (Reuters)—A new front in the battle over the cost of expensive medicines in the United States is opening up in Oklahoma, the first state where the government’s Medicaid program is negotiating contracts for prescription drugs based on how well they work. In June, Oklahoma received approval from the U.S. Centers for Medicare and…
Coding Corner Answer: To Bill or Not to Bill an Eval & Management Visit?
Take the challenge. Scenario 1 is the correct answer. Although documentation of both scenarios supports a Level 4 visit, only one supports the medical necessity to code an evaluation and management (E/M) visit on the same day with a procedure. Scenario 1 supports the need for a separate E/M visit, because a new problem was…
Coding Corner Question: To Bill or Not to Bill an Eval & Management Visit?
Scenario 1 History: A 45-year-old male patient with sero-negative rheumatoid arthritis affecting multiple sites, but with no organ or systems involvement, comes for a follow-up visit. The patient reports swelling of the left knee with throbbing left knee pain. He rates the severity of his pain at an 8 on a 10-point scale. The pain…
5 Ways to Improve Your Collaboration with Orthopedic Surgeons
Rheumatologists and orthopedic surgeons must frequently collaborate to provide optimal patient care. Sometimes, they may even work at the same practice and form a care team for easy collaboration. Still, patient management from both specialties can be challenging, and specialists from both sides can learn from each other. How Crossover Starts Rheumatologists and orthopedic surgeons…
2019 Proposed Rule for MIPS Performance Year 3
The CMS has submitted its annual proposed rule, which continues the transition to a value-based model, for comment by stakeholders and the public for the 2019 MIPS performance year (Jan. 1–Dec. 31, 2019).
ACR Seeks CMS Exemption to Perform Synovial Fluid Crystal Analysis
Marcus Snow, MD, is a rheumatologist in a multispecialty clinic in Nebraska. During the average day, the nephrologist in his clinic can assess urinary sediment. The urologist can examine semen specimens for viability. However, despite clinical training and competency, Dr. Snow and his rheumatology colleagues cannot perform synovial fluid crystal analysis for their patients. The…
Switch to Electronic Health Records Tied to Fewer Hospital Deaths
(Reuters Health)—Hospitals that switch from paper to electronic health records may eventually see lower death rates than they had before, but a U.S. study also suggests that fatalities may first increase as the transition gets underway. Researchers examined the degree of digitization and 30-day death rates for patients age 65 and older at 3,249 hospitals…
Private Practice in Rheumatology: Winners & Losers in the Workforce Numbers Game
In the U.S., the demand for rheumatologists has outpaced the supply of physicians. So how do private practices attract new physicians, and how are practices with physician vacancies managing?
How to Document the Physical Exam
The adage frequently cited in healthcare settings, “If it isn’t documented, it wasn’t done,” still rings true for the key components required in a patient’s medical record. The note in the medical record must sufficiently describe all of the services furnished to patients on a specific date. The essential requirements to appropriately bill a claim…
Coding Corner Answer: Evaluation & Management Documentation Quiz
Take the challenge. B—The presenting problem(s) is what is evaluated during the history and examination by the provider. The chief complaint is in the patient’s own words or is a follow-up for his or her current condition. The history of present illness, along with the review of systems, usually guides the provider through the examination….
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