LATE-BREAKING NEWS Editor’s note: The ACR praises Congressional leaders for passing today’s (2/9) sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauded the inclusion of…
RISE Readiness for MIPS in 2018
In 2018, all providers will have to submit an entire year’s worth of their quality measure data to the CMS. After 2017, the transition year, the requirements and performance thresholds begin to increase. The CMS is still heavily incentivizing participation in a Qualified Clinical Data Registry (QCDR), such as the RISE registry, for reporting in…
U.S. Telehealth Industry Eyes Medicare for Its Next Big Check
(Reuters)—After years of lobbying in Washington, U.S. telehealth providers have the first hints that the dam could break on public funding for an industry they say could save taxpayers billions. Four bills that could be signed into law over the next year carry the solutions to barriers that have prevented the U.S.s’ huge over-65 health…
2018 CPT Coding Updates
Each year the American Medical Association’s CPT code manual is revised to delete codes and/or guidelines, and to add or revise codes to reflect current technologies, techniques and services. Medicare and all other payers are switching to the new 2018 CPT codes for X-rays of the chest. The original codes for a chest X-ray were…

Ethics Forum: Should Doctors Recommend Fitness/Diet Monitoring Devices?
The Case A 58-year-old patient with knee osteoarthritis has been decreasing her physical activity over the past several years due to painful joints, which has resulted in significant weight gain. At her appointment, you encourage her to engage in more physical activity and eat a well-balanced diet. A few weeks later, the patient returns to…

Medicare Access & CHIP Reauthorization Act Preparation Tips
The ABCs of MACRA The transition year under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is at an end. MACRA repealed the Medicare Sustainable Growth Rate (SGR) methodology for updates to the Physician Fee Schedule (PFS) and replaced it with a value-driven payment system. The new approach to payment is called the…
Rheumatology Coding Corner Answer: Querying Documentation for Correct Billing
Take the challenge. No, this claim is lacking proper documentation to be billed out correctly and requires querying the provider before submitting to the payer. First, a query is a written or verbal question concerning the documentation of what is being billed out and should be visible in the patient’s chart. If a query is…
Rheumatology Coding Corner Question: Querying Documentation for Correct Billing
An established, 66-year-old male patient with rheumatoid arthritis who was last seen in the office three weeks before returns to the office for an infliximab infusion. The patient reports mild pain in his right knee, right and left elbows. He rates the pain severity at a 3 on a 10-point scale. He denies any weight…

Electronic Health Record Documentation Guidelines
The operations management team in healthcare practices is expected to have an effective coding compliance program in place that is continually evaluated and reevaluated. To accurately assess the program’s effectiveness, several outcome indicators must be measured, including error rates in the provider’s documentation and the electronic health record (EHR). Due to increased scrutiny by the…

Rheumatology Research Foundation Honors Award Recipients
SAN DIEGO—In November, the Rheumatology Research Foundation honored 155 award and scholarship recipients at the Awards Celebration, an annual luncheon, held in conjunction with the ACR/ARHP Annual Meeting. The event celebrates the accomplishments of rheumatology professionals who have received funding from the Foundation. In congratulating the award recipients, executive director Mary Wheatley, CAE, IOM, emphasized…
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