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
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
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
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…
Rheumatology Research Foundation Hosts Student, Resident Experience at ACR/ARHP Annual Meeting
On Nov. 5, more than 100 students and residents gathered for the Rheumatology Research Foundation’s Student and Resident Experience at the ACR/ARHP Annual Meeting in San Diego. As part of the Foundation’s work to increase the number of rheumatology professionals in the U.S., the event is designed to increase excitement in the field. Attendees enjoyed…
Anthem to Reduce E/M Reimbursement When Billed with Modifier 25
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
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:…
Rheumatology Coding Corner Questions: 2017 End-of-Year Quiz
1. A 68-year-old new female patient has an appointment to see the rheumatologist in four days. The patient has her medical records sent over from her primary care physician, neurologist and endocrinologist for the rheumatologist to review prior to the visit. Upon receipt, the rheumatologist spends 55 minutes reviewing the records and making notes. Can…
Experts Discuss Rheumatologists’ Role in Treating Depression, Anxiety and Psychological Comorbidities in Their Patients
All rheumatologists have observed the impact of their patients’ mental health status on the long-term treatment of rheumatologic conditions. Depression, anxiety and even loneliness can lead to poor clinical outcomes and nonadherence to treatment, whether the patient is following medication regimens or participating in regular exercise. On the other hand, a patient’s resilience and positive…
Tips for Physicians to Stay Focused at Work
All day, technology dings and beeps, phones buzz, staff members need just a moment of your time, and personal issues linger in the back of your mind. With all of the interruptions and potential distractions that occur throughout a day, how do rheumatologists stay focused on patient encounters and work responsibilities? “Arriving at work early…
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