To improve access to quality of care for patients with osteoarthritis and other musculoskeletal pain, the U.S. Department of Veterans Affairs (VA) launched a continuing education program designed to strengthen the musculoskeletal knowledge and skills of primary care providers (PCPs). In the program’s initial trial in 2012, 19 physicians were trained on exams, treatments and joint injections. Two years after course completion, some participants increased the number of intraarticular corticosteroid injections at their clinics without needing to refer patients to specialists…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
What is the ICD-10 guideline to code for osteoporosis without a current pathological fracture? There is no rule. Code for the osteoporosis, and code for the pathological fracture. Code for the osteoporosis from the M81._ category, and code for the history of a pathological fracture. None of the above is correct. How many characters are…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…
Overscreening, Overtreatment of Osteoporosis Common
NEW YORK (Reuters Health)—Too many women who aren’t at risk for osteoporosis are being screened for the disease, and too many women who don’t need osteoporosis treatment are getting it, new research suggests. “In our health system the overtreatment of osteoporosis was common, and this was partly due to the fact that a lot of…
People with Schizophrenia at Higher Risk of Osteoporosis
NEW YORK (Reuters Health)—Pooled data indicate that bone mineral density (BMD) is significantly lower in patients with schizophrenia than in healthy controls, according to Taiwanese researchers. Dr. Ping-Tao Tseng tells Reuters Health by email that the “evidence indicates the importance of further screening for the risk of osteoporosis in young-aged schizophrenic patients . . ….
Combo Drug for Arthritis & Hypertension Meets Goal in Phase 3 Study
(Reuters)—Kitov Pharmaceuticals Holdings Ltd. said on Tuesday its lead drug, KIT-302, met the main goal of a late-stage study, reducing pain without increasing the risk of heart diseases in patients with osteoarthritis. Israel-based Kitov says its drug does not need to be labeled with health warnings, but will instead say it reduces the risk of…
How to Manage Polymyalgia Rheumatica
Recognizing the need to provide guidance on the current disparate management of polymyalgia rheumatica (PMR), the American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), recently published the first international set of recommendations for the screening, treatment and management of PMR.1,2 Specifically, the recommendations offer guidance on the use of…
Exercise Helps Manage Hip Osteoarthritis Pain
(Reuters Health)—Water- or land-based exercise should provide some short-term benefit in pain management for hip osteoarthritis, though there are few well-designed trials testing it, according to a new review. “It is nice to finally have some hip-specific data, as hip and knee osteoarthritis are often grouped together, and it’s almost certain that there are differences…
Pulse-Echo Ultrasound Useful for Osteoporosis Screening
NEW YORK (Reuters Health)—Pulse-echo ultrasound is a useful method for point-of-care osteoporosis screening, researchers from Finland report. “To effectively increase diagnostic coverage, this kind of device should be in every primary or occupational healthcare unit,” Dr. Janne P. Karjalainen from the University of Eastern Finland in Kuopio tells Reuters Health by email. Currently, osteoporosis is…
Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis
CPT: 99213, 73500-RT, 73500-LT ICD-10: M16.52 This E/M service entailed: The history is detailed; The examination is expanded problem focused; and The medical decision making is of low complexity. The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip. M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis…
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