Rheumatology A480 - Complex rheumatology assessment

General Info

Billing Amount: $92.20

Description

A complex rheumatology assessment is an assessment for the ongoing management of the following diseases of the musculoskeletal system where the complexity of the condition requires the continuing management by a rheumatologist: a. Systemic vasculitides; b. Inflammatory myopathies; or c. Polymyalgia rheumatica.

Notes:

1. A complex rheumatology assessment must include the elements of a medical specific reassessment, or the amount payable will be adjusted to lesser assessment fee.
2. This service is not eligible for payment to a physician for the initial evaluation of the patient by that physician.
3. Complex rheumatology assessments are limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.
4. E078 is not eligible for payment with A480.

1. A complex rheumatology assessment is for the ongoing management of complex disorders of the musculoskeletal system, where the complexity of the condition requires the continuing management by a rheumatologist. It is not intended for the evaluation and/or management of uncomplicated rheumatologic disorders (e.g. osteoarthritis, bursitis/tendonitis, neck and back pain).
2. Examples of systemic vasculitides include Churg-Strauss angiitis, polyarteritis nodosa, Wegener’s granulomatosis, Takayasu’s vasculitis, microscopic polyangiitis, and temporal arteritis.
3. A consultation or assessment service, as appropriate, may be claimed for the initial evaluation of a patient. A complex rheumatology assessment is for the ongoing management of a patient with a complex rheumatology disorder.

Related Specialties

Rheumatology Billing codes