Summary & Overview
CPT 3470F: Rheumatoid Arthritis Disease Activity Score (Low)
CPT code 3470F denotes a rheumatoid arthritis disease activity score indicating low disease activity. Nationally, this code documents a standardized clinical measure used in rheumatology to quantify inflammation and pain from rheumatoid arthritis and to guide medication management. Routine capture of this score supports quality measurement, care coordination, and appropriate adjustments in therapy.
Key payers reviewed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the code, expected service settings, and the implications for documentation and billing workflows. The publication outlines common benchmarking and reporting topics tied to this measure such as frequency of assessment, alignment with clinical guidelines, and potential impacts on quality reporting.
This summary equips clinicians, billing staff, and administrators with the clinical context for CPT code 3470F, notes where the code is applied in outpatient rheumatology settings, and identifies the national payers relevant to reimbursement and reporting. Data not available in the input.
Billing Code Overview
CPT code 3470F reports a rheumatoid arthritis (RA) disease activity score that indicates the patient’s level of disease activity. The score quantifies the degree of inflammation and the patient’s level of pain due to rheumatoid arthritis and is used by the provider to assess disease control. The code is reported when the patient has a low RA disease activity score.
Service Type
- Clinical assessment / disease activity measurement
Typical Site of Service
- Outpatient clinic or ambulatory rheumatology practice
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with established rheumatoid arthritis presents for routine follow-up to assess disease control while receiving a disease-modifying antirheumatic drug (DMARD). The clinician administers a validated rheumatoid arthritis disease activity score during the visit, incorporating joint counts, patient global assessment, and laboratory markers as applicable. The score yields a low disease activity result, which is documented in the medical record. The provider discusses the score with the patient and considers maintaining the current therapy. Typical workflow includes: history and focused musculoskeletal exam, completion of patient-reported outcome elements, calculation of the RA disease activity score, documentation of the score and interpretation, and medication reconciliation. This service is performed in an outpatient clinic or rheumatology office during a scheduled follow-up visit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when a distinct E/M visit is provided the same day as score assessment and documented separately |
59 | Distinct procedural service |