Which modifier is used when there is a separate and/or identifiable reason to bill for both an evaluation and management code and a procedure code? -25 -24 -51 -59 Which modifier is used to indicate that bilateral procedures were done on a patient? -50 -LT/RT Both a and b None of the above A 68–year-old…
Search results for: infliximab
Why & How Our Biologic Drug Discussion with Patients Should Evolve
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
Coding Corner Answers: Billing for Joint Injection within a Series
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 Coding/Billing Rationale No evaluation and management (E/M) code was added because there was no significant and/or separate identifiable reason for an E/M service to be billed with this scheduled visit for her series of injections. The joint injection was billed with ultrasound guidance due to…
Predicting the Unpredictable – Taming the Impulse to Treat
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
Can Integrated Care Lead to Better Outcomes?
A typical patient with a rheumatic disease needs a multifaceted treatment approach to address comorbidities, minimize disability, promote quality of life and improve survival. To achieve these outcomes, rheumatology research has evolved from examining a single treatment to studying the best treatment approaches. Examples of these strategy trials include how to best combine pharmaceutical therapies,…
2019 Changes to E/M Documentation
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Coding Corner Questions: A Drug Administration Quiz
A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded? 96413, 96415, J1745 x 50; ICD 10: M05.79 96413, 96415, J1745 x 50;…
The Non-Linear Path of Discovery, & Publicly Funded Research
Black powder was initially developed in 9th century China, by Taoists searching for the philosopher’s stone, which fans of Harry Potter will remember is the talisman that grants eternal life. The Chinese name for black powder literally translates as fire medicine. The chemical composition of black powder was first recorded in China during the 11th…
8 Ways to Help Your Patients with Medication Costs
A patient with rheumatoid arthritis (RA) comes to your office and needs a medication. You prescribe it, and the patient’s insurance plan covers it. The patient begins the medication and slowly but surely feels better. Prescribing drugs for a patient should be this simple but rarely is, thanks to the high cost of drugs and…
Coding Corner Question: Rheumatology Coding & Practice Quiz
1. A 45-year-old female patient with a diagnosis of primary osteoarthritis returns to the office for her second scheduled injection of sodium hyaluronate (Supartz). The nurse takes the patient’s vitals: weight is 185 lbs., height is 5’2”, and temperature is 98.2°F. The patient is prepped and given the injection. How should this encounter be coded?…
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