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…
How Attending Physicians Can Give Fellows Valuable Feedback
If you read The Rheumatologist regularly, you may remember a column I wrote a few months ago about giving and receiving feedback (July 2017). I wrote it when I was finishing fellowship and looking back at six years of my graduate medical education. Now, as an attending physician who spends a considerable amount of time…
Medical Missions Allow Rheumatologists to Volunteer Around the World
For Daniel Albert, MD, a rheumatologist with the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., some of his most defining medical experiences haven’t taken place within his practice, but in exotic locales such as a rainforest on the island of Borneo. One of many physicians across the world who volunteer their time and expertise on medical…
Should Patients with Rheumatic Disease Switch from Biologic to Biosimilar?
SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…
Rheumatologists from Minnesota Team with Dakotas’ Colleagues to Form State Society
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
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
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…
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