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Rheumatologists from Minnesota Team with Dakotas’ Colleagues to Form State Society

Gretchen Henkel  |  January 18, 2018

Generating articles of incorporation, convening boards of directors, establishing nonprofit status: It’s no small feat to form a state rheumatology society, but with the right expertise, the results can be successful, according to the president of the Rheumatology Association of Minnesota and the Dakotas, Jody Hargrove, MD, who is in private practice with Arthritis &…

ACR Advocacy: Past Wins, Future Outlook

Angus Worthing, MD, FACP, FACR  |  January 18, 2018

Greetings, advocates! Your government is back to work after ending a brief government shutdown by passing a short-term continuing resolution (CR), which will keep the government running at current funding levels into February. At some point, it would be great for Congress to pass a budget (instead of a CR) and to enact bipartisan plans…

CMS Approves Policy to Exempt Providers Affected by Natural Disasters from MIPS 2017 Reporting

From the College  |  January 18, 2018

During the 2017 MIPS transition year, eligible clinicians faced many challenges, including extreme and uncontrollable disasters, such as the California wildfires and Hurricanes Harvey, Irma and Maria. In light of this and the understanding that practices may not be able to collect or submit program data for an extended period of time, the Centers for…

Anthem Updates Modifier 25 Policy Changes after Talks with AMA

From the College  |  January 7, 2018

As reported in the Dec. 28 edition of ACR@Work, Anthem Blue Cross recently announced plans to reduce reimbursement for evaluation and management (E/M) services when billed with modifier 25. At the AMA House of Delegates in November, the ACR joined with a number of other groups to support a resolution directing the AMA to advocate…

Update on ACR’s Rheumatology-Specific APM

Mary Beth Nierengarten  |  January 5, 2018

Efforts by the ACR to develop a rheumatology-specific alternative payment model (APM) are well under way. The first draft proposal was approved by the ACR Board of Directors in November and presented to the rheumatology community during the 2017 ACR/ARHP Annual Meeting in San Diego. The ACR is pursuing the development of a rheumatology-specific APM…

Trump Administration Rule Would Let More People Drop Obamacare

Yasmeen Abutaleb  |  January 4, 2018

WASHINGTON (Reuters)—The Trump administration proposed a rule on Thursday to allow Americans who are self-employed or work for small businesses to buy health insurance that does not comply with all Obamacare requirements in an effort to unwind the 2010 healthcare law. The rule, put forward by the Department of Labor, would allow individuals and small…

Developing & Leading a Research Team

Karen Appold  |  December 29, 2017

Translational research is designed to investigate a particular disease process to achieve an improved outcome for patients. Here are some insights into how to bring together the right people for a research team and keep that team focused…

Predatory Publishing: Know the Difference Between a Financial Scheme and Scholarly Dissemination

Carina Stanton  |  December 20, 2017

It happens every day. A new email pops up in a researcher’s in-box from a journal with a seemingly familiar name and an invitation to publish a research paper, present at a meeting or, perhaps, serve on an editorial board. Like many of her colleagues, Marian Hannan, DSc, MPH, professor of medicine at Harvard Medical…

Anthem to Reduce E/M Reimbursement When Billed with Modifier 25

From the College  |  December 20, 2017

Anthem Blue Cross recently announced changes to its reimbursement policies for modifier 25. As of Jan. 1, 2018, Anthem plans in California, Connecticut, Kentucky, Maine, Nevada, New Hampshire, Ohio and Wisconsin will reduce reimbursement for evaluation and management (E/M) services by 50% when billed with modifier 25. This policy will expand to Missouri on Feb….

Rheumatology Coding Corner Answers: 2017 End-of-Year Quiz

From the College  |  December 19, 2017

Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…

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