Marcus Snow, MD, is a rheumatologist in a multispecialty clinic in Nebraska. During the average day, the nephrologist in his clinic can assess urinary sediment. The urologist can examine semen specimens for viability. However, despite clinical training and competency, Dr. Snow and his rheumatology colleagues cannot perform synovial fluid crystal analysis for their patients. The…
CMS Releases 2018 MIPS Eligibility Tool
You can now use the updated Centers for Medicare & Medicaid Services (CMS) MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-Based Incentive Payment System (MIPS). Enter your National Provider Identifier (NPI) in the tool to find out whether you need to participate during the 2018 performance year. Changes to…
CMS Promotes Interoperability with MIPS Category Name Change
The CMS has implemented a few changes to its 2018 MIPS submission categories. Not only will it be adding a cost category, but it has recently announced the renaming of the Advancing Care Information (ACI) category to Promoting Interoperability (PI) to focus on interoperability, improving flexibility and relieving administrative burdens. The CMS confirmed this will…
Avoid Billing Risks for New vs. Established Patients
When coding evaluation and management (E/M) services provided to a patient, one of the most persistent concerns is whether a patient is new or established to the practice. Although this may seem like a simple coding answer, the distinction is an important one, because it enables providers to appropriately bill and receive reimbursement correctly. E/M…
CMS Repeals Documentation Guidelines for Teaching Physicians
As of March 5, physicians no longer have to write their own notes in addition to notes created by students, residents or fellows during patient examinations; instead, providers will only have to verify information documented by the student. Early last month, the Centers for Medicare and Medicaid Services (CMS) reversed the Obama administration policy that prohibited…
Congress Urged to Fix CMS Rule Distorting Part B Drug Reimbursement
LATE-BREAKING NEWS Editor’s note: The ACR praises Congressional leaders for passing today’s (2/9) sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauded the inclusion of…
ACR Continues to Press CMS to Make Changes to E/M Codes
On Dec. 8, 2017, members of the Cognitive Care Alliance (CCA)—of which the ACR is a leading member—met with members of Congress on the Hill and representatives from the Centers for Medicare and Medicaid Services (CMS) to discuss ongoing concerns about the inadequacy of existing evaluation and management (E/M) codes to properly remunerate cognitive services…
Medical Lab Trade Group Sues Over U.S. Reimbursement Cuts
(Reuters)—A U.S. trade association representing medical laboratories filed a lawsuit on Monday challenging a new reimbursement system used by the federal government that it said would reduce how much Medicare pays for labs by about $670 million in 2018. The American Clinical Laboratory Association (ACLA) in a lawsuit in federal court in Washington, D.C., said…
What You Need to Know about the New Medicare Card Project
Beginning in April 2018, Medicare patients will receive newly designed Medicare identification cards that replace their Social Security numbers (SSNs) with unique, randomly assigned, alphanumeric identification numbers. The Centers for Medicare & Medicaid Services (CMS) is making the change to protect patients 65 and older from exposing their SSNs in efforts to “help prevent fraud,…
MACRA Has Arrived—& What You Do Now Counts
Changes to reimbursement introduced by the Medicare Access and CHIP Reauthorization Act (MACRA) will affect your Medicare income for 2019. “Rheumatologists generally know that MACRA is up and running,” says Angus Worthing, MD, FACR, FACP, clinical assistant professor of rheumatology at Georgetown University Medical Center and chair of the ACR’s Government Affairs Committee. “Virtually every…
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