For the first time, five generations are currently employed in the workforce. From traditionalists to gen Z—here are insights into the communication styles of each generation…
Reminder: How to Handle Part D Prior Authorization Requests
As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B, but when it’s used as an oral agent for rheumatoid arthritis, it’s covered by Part D. Early in the…
Medical Records Don’t Always Match What Patients Say
(Reuters Health)—Symptoms that patients describe to doctors may not always be documented in electronic medical records, a small U.S. study suggests. To test out how well the records match reality, researchers compared symptoms that 162 patients checked off on paper-based questionnaires with the information entered in patients’ electronic charts at eye clinics. Roughly one-third of…
RISE Up: The Registry Now Includes More than 4 Million Patient Encounters & Counting
ATLANTA—Despite a downpour outside, ACR and ARHP leaders enjoyed sunny news about the Rheumatology Informatics System for Effectiveness (RISE) Registry at the on Jan. 21. RISE now includes data on more than 4 million patient encounters, and attendees were charged with thinking of ways to increase utilization of the registry and better use its valuable information….
UnitedHealthcare Delays Lab Program Implementation in Texas
As you probably know, the ACR is one of several organizations that has been advocating against the UnitedHealthcare (UHC) Laboratory Benefit Management Program, which was launched in Florida in 2014 and was due to expand to Texas on March 1. The program requires use of certain laboratories and online physician decision support for certain tests,…
Principles Would Streamline Prior Authorization Processes
The ACR recently partnered with the American Medical Association (AMA) and a coalition of 16 other organizations representing physicians, medical groups, hospitals, pharmacists and patients to dramatically reshape prior-authorization protocols. The coalition is urging an industry-wide reassessment of these protocols to align with a newly created set of 21 principles, called the Prior Authorization and…
Rheumatology Coding Corner Answer: Coding for a Knee Injection
CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral primary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in the patient’s medical chart….
Siting Your Rural Rheumatology Practice & Other Rural Rheum Concerns
Do you want to practice near a highway off-ramp or a supermarket? Where a rural rheumatology practice is located may be the key to success…
Rheumatology Coding Question: Deconstructing Evaluation and Management Codes
A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and…
Why Keep a Seat at the AMA Table?
As 2017 unfolds—a year when MACRA begins, lawmakers take steps to dismantle the health reform efforts of the past eight years, and political uncertainty is the rule—it is imperative that the ACR leverage its advocacy agenda by maintaining its seat at the American Medical Association’s (AMA’s) House of Delegates (HOD), says Gary Bryant, MD, FACP…
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