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Practice Support

Subcategories:Billing/CodingEMRsFacilityInsuranceQuality Assurance/ImprovementTechnologyWorkforce

Coding Corner Answers: Billing for Joint Injection within a Series

From the College  |  January 17, 2019

Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 Coding/Billing Rationale No evaluation and management (E/M) code was added because there was no significant and/or separate identifiable reason for an E/M service to be billed with this scheduled visit for her series of injections. The joint injection was billed with ultrasound guidance due to…

Coding Corner Question: Billing for Joint Injection within a Series

From the College  |  January 17, 2019

A 68-year-old female Medicare patient with a diagnosis of primary osteoarthritis of the left knee returns to a practice for her third injection in a series of knee injections. She reports being able to resume her after-dinner walks, which last for 30–40 minutes at least twice weekly. She denies fevers or any rashes. She has…

Rheumatology Clinics Add Pharmacists to Care Teams, See Benefits

Susan Bernstein  |  January 17, 2019

CHICAGO—Could the addition of a pharmacist to rheumatology care teams improve patient satisfaction, decrease staff burnout or reduce medication-related problems? Three panelists in Integrating Pharmacists into the Workforce, a session at the 2018 ACR/ARHP Annual Meeting, shared positive experiences with this interdisciplinary care model. Less Burnout, More Satisfaction Ten years ago, the Arthritis Treatment Center…

Reminder: How to Handle Part D Prior Authorization Requests

From the College  |  January 16, 2019

Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…

Gearing Up for State Legislation in 2019: 5 Issues that Need Your Attention

Carina Stanton  |  January 4, 2019

With a number of new legislators and new governors sworn in this month, 2019 promises to be an exciting year for state-level rheumatology advocacy. “Now is the time to reach out and share our top issues with new legislators in your state,” suggests Joseph Cantrell, ACR senior manager of state affairs. 2019 Priorities ACR Affiliate…

Coding Corner Answers: Rheumatology Word Search

From the College  |  December 18, 2018

Take the challenge. Ultrasound guidance: There must be a permanent picture placed in the patient’s medical chart to meet the requirements of documentation guidelines. Arthrocentesis: This is the proper term for the withdrawal of fluid and/or injection of medication into a joint. If both the aspiration and injection are performed during the same encounter, only…

Coding Corner Questions: Rheumatology Word Search

From the College  |  December 18, 2018

Find the words/terms suggested by the following clues: What is the procedure conducted when a permanent picture is required for a joint injection? What is another name for a joint injection? What should be done when a patient returns for an infusion and a prior authorization has already been approved? On what body system is…

Common Issues That Lead to Claim Denials

From the College  |  December 18, 2018

In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices.  Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…

AFLAR Experts Discuss Highlights, Hurdles in Rheumatology in Africa

Thomas R. Collins  |  December 18, 2018

CHICAGO—Rheumatology physicians and researchers from Africa said the field’s resources and medical literature on the continent are slowly expanding, but they repeatedly lamented that the millions who suffer from rheumatic diseases there have major obstacles to overcome to access care. Their reviews and assessments—sometimes grim and sometimes hopeful—came in a session that was a joint…

Tips for Using Digital Health Tools

Thomas R. Collins  |  December 18, 2018

CHICAGO—Approximately 200,000 health apps are available through major app stores. Some offer real benefits, said Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai Health System, Los Angeles, Calif. But most, he told attendees at the 2018 ACR/ARHP Annual Meeting, are “rubbish.” “They do one or two things only—and generally not well,” he…

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