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Documentation Guidelines for Proper Medical Decision Making

From the College  |  June 13, 2017

The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…

Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient

From the College  |  June 13, 2017

Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…

Rheumatology Coding Corner Question: Infusion Services for Skilled Nursing Facility Patient

From the College  |  June 13, 2017

An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….

Tight RA Control Via Telemedicine Noninferior to Conventional Clinic Visits

Reuters Staff  |  June 12, 2017

NEW YORK (Reuters Health—Telemedicine follow up based on patient-reported outcome (PRO) is noninferior to conventional outpatient care for tight control of disease activity in rheumatoid arthritis (RA) patients with low disease activity or remission, new findings show. “Even though patients in the [telemedicine] follow-up groups requested more acute visits, they over-all had a more than…

A Look at CPT Codes for Prolonged Services

From the College  |  May 31, 2017

In the 2017 Medicare physician fee schedule, the CMS officially activated CPT codes 99358 and 99359 as reimbursable codes for non-face-to-face prolonged services performed in the office or outpatient setting, hospital or nursing facility by physicians or other qualified health practitioners (not clinical staff). The CPT codes are defined as 99358: Prolonged evaluation and management service…

In-Office Pharmacist Improves Patient Care

Karen Appold  |  May 26, 2017

Would your patients and practice benefit from an on-site pharmacist? Jessica Farrell, PharmD, says a pharmacist enhances patient education and frees up a rheumatologist’s time, enabling them to see more patients and provide better all-around care…

Anthem Still Weighing 2018 Obamacare Individual Participation

Caroline Humer  |  May 24, 2017

NEW YORK (Reuters)—Anthem Inc on Wednesday said its plans for selling 2018 Obamacare individual plans are still up in the air because of political and regulatory uncertainty, making it the latest health insurer to say questions about continued funding of government subsidies will affect consumers next year. Anthem, the biggest provider of individual health plans,…

U.S. Teaching Hospitals Are Expensive, But Have Lower Death Rates

Lisa Rapaport  |  May 23, 2017

(Reuters Health)—Academic medical centers, increasingly spurned by insurers for being more expensive than community hospitals, appear to have lower death rates for older adults than other facilities, a U.S. study suggests. Researchers reviewed millions of records for patients aged 65 and older and insured by Medicare, the U.S. health program for the elderly. They found…

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Tips for Managing Young Adult Rheumatology Patients

Gregory Taylor, MSW, RCSW  |  May 18, 2017

Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…

Four-Week Methotrexate Break Improves Flu Shot Response in RA Patients

Reuters Staff  |  May 17, 2017

NEW YORK (Reuters Health)—Temporarily withholding methotrexate (MTX) can improve the efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis (RA), according to a new randomized clinical trial. Response was strongest in patients who discontinued MTX for two weeks before and two weeks after receiving the flu shot, Dr. Eun Bong Lee of Seoul National…

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