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Practice Support

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Rheumatology Coding Answer: Level 3 Established Patient Evaluation and Management Office Visit

From the College  |  August 10, 2016

Take the challenge. CPT: 99213 Diagnosis Codes: M05.79, M17.12, Z79.1, Z79.899 Rationale to code this encounter as 99213: History—The history of present illness was extended. The review of systems was comprehensive, and two of the three past, family and social history were documented. This makes the history level comprehensive. Eight systems were examined. This makes…

Rheumatology Coding Question: Level 3 Established Patient Evaluation and Management Office Visit

From the College  |  August 10, 2016

Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….

Rheumatology Informatics System for Effectiveness (RISE) Registry Can Help Rheumatologists Meet MACRA Requirements

Joan M. Von Feldt, MD, MSEd, FACR, FACP  |  August 10, 2016

The ACR has been at the forefront of helping rheumatologists meet practice demands, including federal reporting requirements. The first registry that helped meet these requirements was the Rheumatology Clinical Registry (RCR), and it facilitated quality reporting, but required manual entry of required data. More recently, ACR has contracted with FIGmd to create a tool that…

Ixekizumab Improves Work Productivity in Patients with Plaque Psoriasis

Michele B. Kaufman, PharmD, BCGP  |  August 10, 2016

In three clinical trials, ixekizumab proved more effective than placebo or etanercept at increasing the work attendance and productivity of patients with plaque psoriasis…

How to Leverage Patient Satisfaction

Richard Quinn  |  August 5, 2016

Medicare and other insurers are using patient satisfaction to determine provider payment. But according to one expert, rheumatologists who look at their practice with a critical eye, listen and ask their patients the right questions may improve their patient relationships and their practice…

How Sick Is Your Patient? Document the Details!

Carol Patton  |  August 4, 2016

Clear. Complete. Concise. These three Cs describe ideal patient record keeping, which is why they are among the key reasons to implement a clinical documentation information (CDI) program into your rheumatology practice. Not only will CDI help you accurately document the full picture of each patient’s clinical status, but it also promotes high-quality care and…

Proposed CMS Physician Fee Schedule May Offer Slight Increases

Carol Patton  |  August 4, 2016

All eyes are on the new physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS), which will be finalized this year and go into effect Jan. 1. The ACR is reviewing the proposal and will be providing comments and recommendations to CMS. And many rheumatologists have payment and coding questions: Will…

Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research

Donah Zack Crawford, MA, Jill Johnson, MD, Neal K. Moskowitz, MD, PhD, & James Udell, MD  |  July 14, 2016

Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…

Rheumatology Coding Corner Answer: Physical Examination with Infliximab Infusion

From the College  |  July 14, 2016

Take the challenge. CPT: 99214-25, 96413, 96415 x 1, J1745 x 35 ICD-10: M07.68, K51.80 Billing Overview It is appropriate to bill for an E/M visit for this day of service along with the infusion procedure. Modifier 25 should be appended to the E/M, indicating that the patient received a significant, separately identifiable E/M service…

Rheumatology Coding Corner Question: Physical Examination with Infliximab Infusion

From the College  |  July 14, 2016

A 12-year-old male established patient with inflammatory bowel disease with associated juvenile spondyloarthropathy returns to the office for a follow-up visit for his infliximab infusion. The patient reports moderate pain in his right hip after walking for extended periods of time or after sports activities. He denies any other joint pain and denies any joint…

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