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Rheumatology Coding Corner Question: Billing for an Inflectra Infusion

From the College  |  May 17, 2018

A 68-year-old female patient returns to the office for a second round of Inflectra (infliximab-dyyb) infusion for her rheumatoid arthritis with rheumatoid factor of multiple joints without organ or systems involvement. She reports pain, stiffness and swelling in her left and right knees and right elbow and rates the pain at a 9 on a…

3 Ways to Improve How You Work with Doctors from Other Specialties

James T. Rosenbaum, MD  |  May 17, 2018

Many trainees tell me they’re attracted to rheumatology because it demands becoming a complete physician. We need knowledge of the brain, eye, lung, kidney, liver, skin, bones and vascular system to be effective rheumatologists. And because our diseases are frequently multisystem diseases, rheumatologists must be the quintessential collaborators. For more than 30 years, I’ve directed…

The Social Workers’ Role in Rheumatology Care & Patient Advocacy

Karen Appold  |  May 8, 2018

Patients with rheumatic disease require a team of specialists working together to meet the patient’s needs. Social workers can advocate for these patients and play a variety of other roles to help them manage their disease…

At the Table: ACR Meets with MedPAC

Carina Stanton  |  May 4, 2018

The Medicare Payment Advisory Commission (MedPAC) makes recommendations to Congress on Medicare policy including physician payments and patient access issues. These recommendations can directly impact rheumatology care coverage and rheumatologist reimbursement. Representatives of the ACR and partners recently met with new MedPAC Executive Director James E. Mathews, PhD, to discuss appropriate recognition of rheumatology care…

CMS Releases 2018 MIPS Eligibility Tool

From the College  |  May 4, 2018

You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-Based Incentive Payment System (MIPS). Enter your National Provider Identifier (NPI) in the tool to find out whether you need to participate during the 2018 performance year. Changes to Low-Volume Threshold To reduce the burden on…

New Compounding Regulations could Adversely Affect Rheumatologists, Patients

Kelly Tyrrell  |  May 4, 2018

On July 28, 2018, the USP will publish preliminary updates to existing drug compounding standards that could affect whether rheumatologists maintain the ability to mix, combine or otherwise customize medications in office for individual patient use. The ACR, in concert with the American Medical Association (AMA) and others, is working to help ensure rheumatologists can…

Clinical Remission Should Be Target of JIA Treatment: Task Force

Reuters Staff  |  April 27, 2018

NEW YORK (Reuters Health)—An international task force says patients with juvenile idiopathic arthritis (JIA) should be treated to a target of clinical remission, among other new recommendations. “The Task Force is convinced that transferring (the recommendations) into clinical practice will significantly improve the outcomes in patients with JIA,” Dr. Angelo Ravelli of the Istituto G….

Telehealth Is Helping the Underserved

Linda Childers  |  April 26, 2018

For many uninsured and underinsured patients in Yuba City, Calif., seeing a rheumatologist used to mean taking a day off from work and driving 108 miles, roundtrip, to the University of California Davis Medical Center. That changed this year when patients were offered the option of having a telemedicine consultation with a rheumatologist as part…

ACR Insurance Subcommittee Responds to Payer Policies

From the College  |  April 26, 2018

Since the beginning of the year, the ISC has sent eight letters to payers in response to problematic policies. Each letter outlines the ACR’s concerns and requests corrective action…

Rheumatology Coding Corner Answer: RA Follow-Up with Imaging

From the College  |  April 26, 2018

Take the challenge. CPT codes: 99214, 71045, 86580 ICD-10: M05.79, R05, R06.2 History—Detailed: The history of present illness (HPI) was extended; the review of systems (ROS) was extended; and the past medical, family and social history (PFSH) were documented. All three components of the HPI, ROS and PFSH are needed to achieve the detailed history…

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