CHICAGO—ACR leaders described a series of looming legislative and regulatory threats to rheumatologists and their patients—including the proposed collapsing of evaluation and management (E/M) coding and potential changes to step therapy rules—and urged everyone in the field to make their voices heard to quash the proposals. They also recounted recent victories in the policy realm…
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Improve Your Claim Submissions Process
Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as…
Coding Corner Answer: Rheumatology Coding & Practice Quiz
Take the challenge. B or D—If it was not documented, it was not done is the motto of many coders. For those who follow this motto, the answer would be B. But there is another option for the coder and that is to query the physician about whether the injection was done with ultrasound guidance…

Big Data May Shift Reference Ranges for Some Lab Tests
How will big data mined from huge sample sizes in research cohorts, electronic health records, personal health data (e.g., heart rates from Fitbits) and insurance claim data sets change the way physicians interpret something as simple as complete blood count (CBC) test results for individual patients? According to the authors of a paper in the…

Registered Nurses Provide Valuable Support to Rheumatology
In a rheumatology practice, registered nurses take on multiple roles, from administrative tasks to engaging in patient support and assessment. They can aid rheumatologists and help provide the best care to patients…
Aetna, Seeking Antitrust Nod, Sells Medicare Drug Business to WellCare
(Reuters)—Health insurer Aetna Inc said on Thursday it will sell its standalone Medicare prescription drug plan business to WellCare Health Plans Inc as it seeks U.S. antitrust approval for a planned acquisition by CVS Health Corp. The $69 billion CVS-Aetna deal would be the second large deal this year between insurers and pharmacy benefit managers,…
Fellows Find Their Voices on Capitol Hill
In 2015, as a rheumatology fellow, Christina Downey, MD, attended the inaugural ACR Advocacy 101 course, put on by rheumatologists Blair Solow, MD, and Sarah Doaty, MD. “I thought it was incredibly informative, and I was really surprised at how much legislators and staff did not know about rheumatology, or what it’s like to be…
ICD-10 Code Change Proposed
On Sept. 12, the ACR and the Sjögren’s Syndrome Foundation presented an ICD-10 code change request for Sjögren’s syndrome to the ICD-10 Coordination and Maintenance Committee (C&M) at the CMS office in Baltimore. The request is intended to clarify ICD-10 M35.0: sicca syndrome [Sjögren]. Why Change the Code? The rationale behind this significant change request…
Advocates for Arthritis Push for Policy Changes at Annual Event
The ACR advocates on behalf of the rheumatology community throughout the year, but it’s always especially exciting when patients join our efforts in Washington, D.C. Close to 100 patients, rheumatologists and representatives of the broader interprofessional team traveled to our nation’s capital this week to participate in the ACR’s annual Advocates for Arthritis event. Participants…

Is Concierge Medicine Right for Your Practice?
It is no surprise to practicing physicians that the healthcare landscape is becoming more and more unpredictable. Because of the volatility surrounding today’s healthcare environment, such as increasing overhead costs and decreasing reimbursement rates, many physicians are asking themselves whether there is a different, more lucrative way to practice medicine. Concierge medicine may just be…
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