A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and…
Ethics Forum: Ethical Challenges Arise for Rheumatologists Pressed to See Patients of High Social, Professional Standing Before Others
The Case You’re working in a busy rheumatology practice with wait times of two to three months for new outpatient consultations. A hospital administrator requests that his daughter see you right away. All but one of your urgent appointment slots for the week is already filled, and there are several patients on a waitlist; these…
Electronic Medical Records Have Mixed Impact on Quality, Quantity of Healthcare
The widespread implementation of electronic medical records (EMRs) and electronic health records (EHRs) has significantly changed the quality and quantity of healthcare for both the better and the worse. The digitalization of medical records provides comprehensive documentation of all events and actions associated with an individual’s medical care. Likewise, legibility, accountability and credibility are greatly…
Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…
Cyber Safety in the HIPAA Age
Ready for a cyber checkup? Auditing your health IT policies, safeguarding your hardware and educating your staff on the importance of data security should be routine, according to industry experts…
How Hospital Design Can Promote Better Patient Outcomes
A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…
2015 ACR Workforce Study Report Offers Rheumatologists Chance to Improve Patient Care, Financial Outlook
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
Rheumatology Coding Corner Year-End Quiz Answers
Take the challenge. D—As of January 2015, there are three new codes added to the arthrocentesis codes of 20600–20611. The new codes, 20604, 20606 and 20611, should be reported when the procedure is performed with ultrasound guidance and CPT 76942 should not be billed separately. The three new codes are defined as: 20604—Arthrocentesis, aspiration and/or…
New Physician Payment Reforms Highlight Need for Quality Coding, Accurate Documentation
To be an effective practice owner, it is necessary to understand the financial circumstances and environment of the practice’s operation. Well-managed practices prevent the loss of time and money. Therefore, to improve productivity and operating efficiencies, you need to have a basic understanding of billing and payment initiatives that will impact the practice’s bottom line….
Rheumatology Coding Corner Year-End Quiz Questions
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
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