SAN FRANCISCO—“Interstitial lung disease is the last bastion of great medicine,” according to Paul Noble, MD, chair, Department of Medicine, director, Women’s Guild Lung Institute, Vera and Paul Guerin Distinguished Chair in Pulmonary Medicine, Cedars-Sinai Medical Center, Los Angeles. Making it great medicine, he said, are the many things still unknown about this disease. In…
When the code that you need is not clear Just keep this poem quite near If you’re struck by a parrot Just grin and bear it ICD-10 has you covered my dear. W61.02XA Struck by parrot, initial encounter And if you’re ever struck by a cow I don’t even want to know how Rest assured:…
SAN FRANCISCO—Two hundred years ago, physicians knew nothing about what caused various forms of arthritis. Today, we have more clues about what may trigger rheumatic diseases, but still can’t pinpoint the culprits that set scores of inflammatory conditions in motion. Researchers discussed some of the background and recent findings that point to what immunologists call…
At the 2015 ACR/ARHP Annual Meeting in San Francisco in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the December 2015 issue, The Rheumatologist reported on the ACR’s awards. This month, we speak with the ARHP winners about…
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
FDA Updates Belbuca, buccal-administered buprenorphine, has received U.S. Food and Drug Administration (FDA) approval for treating severe chronic pain.1 The dosage form is a dissolving film that is absorbed through the inner lining of the cheek for chronic pain management. It’s expected to be commercially available in the first quarter of 2016. Seven dosage strengths…
2015 Mary Betty Stevens Young Investigator Prize Awarded to Dr. Timothy Niewold Timothy B. Niewold, MD, Mayo Clinic rheumatologist and associate professor of medicine at the Mayo Clinic College of Medicine, Rochester, Minn., was awarded the 2015 Mary Betty Stevens Young Investigator Prize at a reception held during the 2015 ACR/ARHP Annual Meeting in San…
Over the course of a month, you diagnose systemic sclerosis in two newly evaluated patients. Their responses to the news could not be more different. Patient 1 is a previously healthy 55-year-old man who is an avid bicyclist and skier. He presents with a several-month history of rapidly progressive skin tightening extending to the proximal…
SAN FRANCISCO—To unravel the mysteries of how autoimmunity begins in the body and, one day, to interrupt that process, rheumatology researchers are exploring the role of neutrophils, especially when they form and release neutrophil extracellular traps (NETs). At a panel discussion on Nov. 6, 2015, held at the American College of Rheumatology’s Basic Research Conference,…
Rheumatoid arthritis (RA) can be defined as a chronic autoimmune systemic inflammatory condition characterized by symmetrical polyarthritis. Typically, patients present with pain, stiffness and warmth of the affected joints. The condition can result in extra-articular features, adding to disability, and may eventually lead to premature death, especially if not treated early and appropriately.1,2 Over the…
Diagnosing rheumatoid arthritis (RA) early in the disease process is ideal, because treatments are more likely to be effective and less damage will occur. Guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) state that using newer biologic medications, in addition to more aggressive dosing of traditional medications, is…
View the question. Findings/Diagnosis An anteroposterior (AP) radiograph of the right foot shows hallux valgus of the first metatarsal phalangeal (MTP) joint, erosive changes at the first and fifth metatarsal bones and degenerative changes at the fourth and fifth metatarsal-cuboid joints. An AP radiograph of the left foot shows extensive erosive and degenerative changes at…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 33-year-old woman with a 16-year history of systemic lupus erythematosus…
Ethiopia has a rich, variable and distinguished history and landscape. Located in the Horn of Africa, it shares borders with Eritrea, Djibouti, Somalia, Kenya, Sudan and South Sudan. Ethiopia has claim to the oldest humanoid fossils, named “Lucy,” which were discovered in 1974 and are estimated to be 3.2 million years of age.1 The country’s…
Different parts of Medicare cover different services. For outpatient prescription drugs, Medicare has two distinct programs with a maze of complex policies. Most physicians along with Medicare patients, retail pharmacies, Medicare drug plans as well as Medicare Advantage health plans continuously struggle with navigating Medicare drug coverage under Part B and Part D. There are…
The ACR advocates on behalf of rheumatologists, rheumatology health professionals and the rheumatology community through involvement in federal and state legislation and regulatory action, participation in hearings and education of lawmakers on issues important to rheumatologists, health professionals and patients. Through robust federal and state advocacy programs, the ACR engages lawmakers and informs them of…
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…
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…
It’s easier than ever to become a part of advocacy efforts at the federal and state levels. Visit the ACR’s new Legislative Action Center to send a personalized message to your lawmakers, asking them to give patients access to treatments, to provide funding for biomedical research and to prevent insurer practices from interfering with treatment…
Nearly 150 of the Rheumatology Research Foundation’s most generous supporters gathered in November during the 2015 ACR/ARHP Annual Meeting for the Donors of Merit recognition event. In celebration of the Foundation’s 30th Anniversary in 2015, the event reflected on the journey to advance treatments and improve patient care. The Foundation’s president, David Karp, MD, PhD,…
It’s a scenario that occurs all too often. After you tell someone you’re a rheumatologist, you receive that look—the blank stare, as if you’ve spoken to them in a foreign language. Six years ago, this scenario sparked a conversation among the ACR’s leaders about the importance of promoting our profession to the public, including key…
Every so often, a major scientific breakthrough profoundly alters the trajectory of scientific research. In the 1960s, microbiologists sparked the recombinant-DNA revolution with the discovery that bacteria have innate immune systems based on restriction enzymes. These enzymes bind and cut invading viral genomes at specific short sequences, and scientists rapidly repurposed them to cut and…
As a rheumatologist, you’re used to having goals. After all, you set your sights on becoming a physician, achieved the necessary educational degrees and passed required exams. After meeting your educational goals, you landed a job at an academic medical center or an established rheumatology practice, or you may have started your own practice. So…