How To Use CPT Code 3470F

CPT 3470F describes the disease activity level of a patient with rheumatoid arthritis (RA) and is used to assess the degree of inflammation and the patient’s level of pain. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 3470F?

CPT 3470F can be used to determine the disease activity level of a patient with rheumatoid arthritis (RA). This code helps assess the degree of inflammation and the patient’s level of pain due to RA. The provider may adjust the patient’s RA medication based on the results of this score. CPT 3470F is reported when a patient has a low RA score.

2. Official Description

The official description of CPT code 3470F is: ‘Rheumatoid arthritis disease activity, low (RA).’

3. Procedure

1. The provider evaluates the patient’s rheumatoid arthritis disease activity using a combination of measures, including the number of swollen or tender joints, erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels in the blood to measure inflammation, and the Visual Analogue Score (VAS) to determine the level of pain.

4. Qualifying circumstances

Patients eligible for CPT 3470F are those with rheumatoid arthritis (RA) who require assessment of their disease activity level. Rheumatoid arthritis is an autoimmune disorder that causes inflammation of the joints, resulting in deformity, pain, and loss of function. The disease activity score helps evaluate the extent of inflammation and pain in the patient. A disease activity score between 2.6 and 3.2 indicates a low disease activity level.

5. When to use CPT code 3470F

CPT code 3470F should be used when assessing the disease activity level of a patient with rheumatoid arthritis (RA). It is appropriate to report this code when the patient’s disease activity score falls within the range indicating low disease activity. However, it should not be used for patients with moderate or high disease activity levels.

6. Documentation requirements

To support a claim for CPT code 3470F, the provider must document the following information:

• Patient’s diagnosis of rheumatoid arthritis
• Date of the disease activity assessment
• Results of the disease activity score, including the number of swollen or tender joints, ESR or CRP levels, and VAS
• Any adjustments made to the patient’s RA medication based on the disease activity level

7. Billing guidelines

When billing for CPT code 3470F, ensure that the patient has a documented diagnosis of rheumatoid arthritis and that the disease activity level falls within the range indicating low disease activity. This code should not be reported with other codes related to moderate or high disease activity levels. Providers should follow the specific guidelines provided by the payer for accurate billing and reimbursement.

8. Historical information

CPT code 3470F was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A rheumatologist assessing the disease activity level of a patient with rheumatoid arthritis (RA) and documenting a low disease activity score.
2. A primary care physician evaluating the disease activity level of a patient with RA and adjusting their medication based on the low disease activity score.
3. An orthopedic specialist measuring the disease activity level of a patient with RA and recommending appropriate treatment options for their low disease activity.
4. A rheumatology nurse practitioner documenting the disease activity score of a patient with RA and providing education on self-management strategies for low disease activity.
5. A rheumatoid arthritis support group facilitator conducting disease activity assessments for group members and identifying those with low disease activity for targeted interventions.
6. A rheumatology physician assistant monitoring the disease activity level of a patient with RA and collaborating with the patient’s rheumatologist to develop a treatment plan for low disease activity.
7. A rheumatology nurse conducting regular disease activity assessments for patients with RA and referring those with low disease activity to physical therapy for symptom management.
8. A rheumatoid arthritis patient tracking their disease activity scores over time and sharing the results with their healthcare provider during follow-up appointments.
9. A rheumatology resident learning how to accurately assess the disease activity level of patients with RA under the supervision of an experienced rheumatologist.
10. A rheumatology clinic implementing a standardized protocol for assessing disease activity in patients with RA and using CPT code 3470F to document low disease activity levels.