How To Use CPT Code 4187F

CPT 4187F describes the prescription or dispensation of disease modifying antirheumatic drug therapy for patients with rheumatoid arthritis. This article will cover the description, official definition, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 4187F?

CPT 4187F can be used to report the prescription or dispensation of disease modifying antirheumatic drug therapy for patients with rheumatoid arthritis. These drugs are used to reduce pain and inflammation by suppressing the overactive immune and inflammatory system in the body. The provider closely monitors the therapy and may prescribe one or more medications for long-term use, depending on the patient’s response to treatment.

2. Official Description

The official description of CPT code 4187F is: ‘Disease modifying anti-rheumatic drug therapy prescribed or dispensed (RA).’ This code indicates that the provider has prescribed or dispensed disease modifying antirheumatic drug therapy for a patient with rheumatoid arthritis.

3. Procedure

1. The provider assesses the patient’s condition and determines the need for disease modifying antirheumatic drug therapy.
2. A suitable medication or combination of medications is selected based on the patient’s specific needs and response to treatment.
3. The provider prescribes or dispenses the medication(s) to the patient.
4. The patient is closely monitored to ensure the therapy is effective and not causing any adverse effects.
5. Lab tests may be ordered to assess the patient’s liver, kidney, and blood function.
6. The provider documents the prescription or dispensation of the medication(s) in the patient’s medical record, including the date.

4. Qualifying circumstances

CPT 4187F is used for patients with rheumatoid arthritis who require disease modifying antirheumatic drug therapy. Rheumatoid arthritis is a chronic disease characterized by inflammation in the joints. The therapy aims to suppress the overactive immune and inflammatory system to reduce pain and inflammation. The provider must closely monitor the patient’s response to treatment and may order lab tests to ensure the therapy is not causing any harm to the patient’s liver, kidney, or blood.

5. When to use CPT code 4187F

CPT code 4187F should be used when the provider prescribes or dispenses disease modifying antirheumatic drug therapy for a patient with rheumatoid arthritis. It is important to accurately document the prescription or dispensation of the medication(s) in the patient’s medical record.

6. Documentation requirements

To support a claim for CPT code 4187F, the provider must document the following information:

• Patient’s diagnosis of rheumatoid arthritis
• Prescription or dispensation of disease modifying antirheumatic drug therapy
• Date of the prescription or dispensation

7. Billing guidelines

When reporting CPT code 4187F, ensure that the provider has prescribed or dispensed disease modifying antirheumatic drug therapy for a patient with rheumatoid arthritis. This code should not be reported if other related codes have already been used within the same timeframe. It is important to follow the specific guidelines provided by the payer when submitting claims for CPT code 4187F.

8. Historical information

CPT code 4187F was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates or changes to the code since its addition.

9. Examples

1. A rheumatologist prescribes a disease modifying antirheumatic drug therapy for a patient with rheumatoid arthritis to reduce pain and inflammation in the joints.
2. A primary care physician dispenses a medication to a patient with rheumatoid arthritis to suppress the overactive immune and inflammatory system.
3. An orthopedic specialist prescribes a combination of medications for a patient with rheumatoid arthritis to manage their symptoms and improve their quality of life.
4. A rheumatologist prescribes a long-term disease modifying antirheumatic drug therapy for a patient with severe rheumatoid arthritis to prevent further joint damage.
5. A nurse practitioner dispenses a medication to a patient with rheumatoid arthritis to alleviate pain and inflammation in the joints.
6. A rheumatologist prescribes a disease modifying antirheumatic drug therapy for a newly diagnosed patient with rheumatoid arthritis to initiate treatment and prevent disease progression.
7. A primary care physician dispenses a medication to a patient with rheumatoid arthritis to improve their mobility and reduce joint stiffness.
8. An orthopedic specialist prescribes a medication for a patient with rheumatoid arthritis to manage their symptoms and prevent flare-ups.
9. A rheumatologist prescribes a combination of medications for a patient with rheumatoid arthritis to achieve better control of their disease and improve their overall well-being.
10. A nurse practitioner dispenses a long-term medication to a patient with rheumatoid arthritis to slow down the progression of the disease and preserve joint function.