The American Medical Association consists of two key groups: 1) the Relative Value Scale Update Committee (RUC), which oversees the annual updates to the physician work relative values, and 2) the Current Procedural Terminology (CPT) Editorial Panel, which assigns new or revised codes in the CPT book. The CPT Process Current Procedural Terminology (CPT) was…
Four years ago, a series of articles in The Rheumatologist talked about the practice of rheumatology in rural settings. Since then, changes have occurred, with the passage of the Affordable Care Act (ACA), differences in reimbursement and the trek toward value-based payment systems. One major concern expressed in the original article was the fact that…
On Nov. 2, 2015, President Barack Obama signed the Bipartisan Budget Act of 2015 (the Act) into law. This critical piece of legislation raises the federal debt ceiling and provides the framework for the federal budget through 2017. Of particular importance, the Act significantly changes the way Medicare will reimburse hospitals for outpatient services furnished…
Two months into the transition, the ICD-10 code set is still not exactly the most enticing reading material. But there is still so much to learn and apply, that it is necessary for physicians, coders and billers to stay abreast of the coding and billing guidelines. Although all of the guidelines and conventions may be…
One month has passed since the U.S. healthcare system overcame a historical milestone with the conversion from billing ICD-9-CM to ICD-10-CM. Although the transition to ICD-10 had a major impact on coding operations, its far-reaching tentacles go beyond coding alone and are deeply rooted in the entire revenue cycle. There is room to criticize the…
The ACR Practice Management and Coding department will periodically update the membership on the new ICD-10 coding guidelines and conventions to assist practices with accurate billing. Our top question during the first week of ICD-10 implementation was on the use of unspecified codes…
The Centers for Medicare & Medicaid Services is attempting to update the reimbursement process for Medicaid, which might relieve administrative burdens on specialists and improve access to services.
How to set up a strategic plan to appeal denied medical claims
The ACR’s Rheumatology Clinical Registry can help physicians meet reporting requirements of the Physicians Quality Reporting System
Denials management is a growing issue in physician practices nationwide, and your practice could be losing tens of thousands of dollars yearly if you do not have a denials-management strategy in place.