Wondering if you will be subject to 2017 payment penalties associated with the PQRS and the Value Modifier? Practices have until Nov. 30 to file for an informal data review.
Brave New MACRA World
Sweeping changes in how physicians are paid for patient care are on the way. The Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015, or MACRA, tossed out the Sustainable Growth Rate formula and ties reimbursement to quality measures. A Helpful Presentation Because 2017 is the first performance year under the new…
Road Rules for Social Media: As More Rheumatologists Go Online to Tweet, Chat or Post, They Must Learn How to Tread Wisely
For many practices, the benefits of social media—connecting with patients and exchanging ideas with colleagues—outweigh the risks, says R. Swamy Venuturupalli, MD, FACP. If rheumatologists set strategies for engagement and help shape the conversations, social media can be leveraged for research, community outreach, patient support and more…
Racial Bias Found in Pain Assessment, Management, Treatment Recommendations by Clinicians
In the world of evidence-based medicine, basing diagnosis and treatment decisions on belief instead of data seems anachronistic. And yet … clinicians are human, and humans live in culture, and culture is formed by beliefs, and beliefs (consciously or unconsciously) drive perception and, often, action. So a new study shining a light on racial bias…
How Rheumatologists Can Improve Patients’ Satisfaction, Patient Care, and Survey Scores
Many reasons exist to strive for high patient satisfaction, including those related to maintaining certification requirements, risk management, reimbursement and simply having a competitive practice, but the most important one is that by achieving high patient satisfaction, you will find that your patients will be more motivated and more engaged in their individual care, says…
Human Resources Management 101 for Physician Practice Owners
In any practice, the physician owner and/or administrators are in charge of overseeing the responsibilities associated with human resources management. This includes employment and labor laws, government compliance issues, employee-related costs and the ever-present threat of employee litigation. The central components of human resources management include staffing the practice; staying current with the legal environment;…
Rheumatology Coding Corner Answer: Gout Visit for Established Patient
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
Rheumatology Coding Corner Question: Gout Visit for Established Patient
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
ICD-10 2.0: An Evolving Data Set
One year after the official go-live of the International Classification of Diseases, 10th revision (ICD-10), the coding language is scheduled to undergo an evolution, with nearly 1,975 additions, more than 300 deletions and 425 revisions. This brings the total set of diagnosis codes to more than 71,480. The new and revised clinical modification codes (ICD-10-CM)…
UHC Expands Pilot Lab Benefit Management Program
UnitedHealthcare recently announced plans to expand its pilot Lab Benefit Management Program to Texas, as of March 1, 2017. The pilot program, which is administered by BeaconLBS, was first launched in Florida in October 2014. Under the pilot, providers are required to use a tool called Physician Decision Support to order certain labs for UHC…
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