The ACR is taking steps to clarify a proposed rule from the Centers for Medicare and Medicaid Services (CMS) that, as currently written, would consider the cost of Part B drugs when calculating physician reimbursement under the Merit-Based Incentive Payment System (MIPS). “The ACR is concerned about this, because large cuts to reimbursement for pass-through…
Final Quarter for 2017 MIPS Reimbursement Has Begun
The final stage of reporting for the Merit-Based Incentive Payment System (MIPS) began Oct. 2, 2017, if you chose the option to report for 90 consecutive days. The MIPS transition year began Jan. 1, 2017, and runs until Dec. 31, 2017. If you subscribed to the Centers for Medicare & Medicaid Services’ (CMS) email, you…
Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2
Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…
Rheumatology Coding Corner Question: Prolonged Service without Direct Patient Contact, Part 2
An established, 66-year-old male patient is seen in the office for a follow-up visit for his fibromyalgia. The physician makes the decision to prescribe venlafaxine for anxiety and depression, and gabapentin for nerve pain. After the visit, the physician informs his medical assistant (MA) to contact the patient’s insurance carrier because venlafaxine requires a prior…

The ARHP Helps Rheumatology Professionals Avoid Information Overload
In a world where some information is good, more information is better and information overload is a way of life, Carole Dodge, BS, OTR, CHT—a practicing occupational therapist at the University of Michigan—considers the ARHP her professional block and tackle. “ARHP helps me sift through a lot of information and get it to a digestible…

Tips to Manage, Prevent Medical Billing Claim Denials
Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…

The ACR, Rheumatology Research Foundation Partner to Expand Rheumatology Workforce
The Rheumatology Research Foundation and the ACR are committed to advancing the future of rheumatology to support patients living with rheumatic diseases. These organizations are focused on addressing one of the most critical issues facing patients and rheumatology today—the growing shortage of rheumatology professionals. The ACR’s 2015 Workforce Study revealed the dire need for support…
After Medical Errors, Patients Want Doctors to Hear Them Out
(Reuters Health)—When medical errors lead to serious injuries, patients and families may feel better when doctors take the time to listen to their feelings about the mistake and explain what can be done to prevent it from happening again, a small study suggests. The research team interviewed 27 patients, three family members and 10 staff…

Tips for Recruiting Rheumatologists
Rheumatology is facing a clinician shortage, so attracting the right candidate for your practice may require an aggressive strategy, from recruiting right out of fellowship programs to offering student loan repayment and flexible work schedules…

MACRA: Tips & Tools for Rheumatology Staff
All healthcare professionals who work in rheumatology had to start adapting to a new landscape of reporting and documentation on Jan. 1 of this year when the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act, or MACRA, began. As the changeover continues, the Sunday ARHP session, Your New Role in the Era of…
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