BALTIMORE—Rheumatologists may not think about osteoporosis on a daily basis, but they should, said Dr. Karl Insogna, the Ensign Professor of Medicine at Yale University School of Medicine and director of the Yale Bone Center in New Haven, Conn., in his recent lecture at the Maryland Society for the Rheumatic Diseases. With approximately 75 million…
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Circulating microRNAs May Serve as Osteoporosis Biomarkers
New research suggests circulating hsa-miR-122-5p and hsa-miR-4516 may become diagnostic biomarkers for osteoporosis. The study found the presence of these microRNAs were associated with osteoporotic fragility fractures and reduced bone mineral density…
When Is It Appropriate to Discontinue Bisphosphonates?
CHICAGO—A 75-year-old woman with low bone density, who has had a fracture and has other risk factors for fracture, is treated with the bisphosphonate alendronate. After five years on the drug she comes back, wondering: Should I stop taking the drug? She’s had no additional fractures. Her bone density has improved, but her lumbar spine…
Romosozumab Has Biggest BMD Benefit in First Year of Treatment
NEW YORK (Reuters Health)—Romosozumab shows smaller benefits for increasing bone mineral density (BMD) in the second year of treatment compared to the first, new research suggests. The extension of a phase 2 study in postmenopausal women with low bone mass also found BMD decreased sharply when patients on romosozumab were switched to placebo after two…
Rheumatology Coding Corner Answers: 2017 End-of-Year Quiz
Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…
Rheumatology Coding Corner Questions: 2017 End-of-Year Quiz
1. A 68-year-old new female patient has an appointment to see the rheumatologist in four days. The patient has her medical records sent over from her primary care physician, neurologist and endocrinologist for the rheumatologist to review prior to the visit. Upon receipt, the rheumatologist spends 55 minutes reviewing the records and making notes. Can…
The ACR Lobbies Against New Part B Drug Cost Adjustment Rule
The ACR and a number of other physician medical associations are lobbying for an immediate legislative fix to a piece of the MACRA law that factors high-cost Part B drugs into a rheumatology practice’s Medicare reimbursement rate through the Merit-Based Incentive Payment System (MIPS). This change, which goes into effect immediately, will impact practices in…
Bisphosphonates May Limit Fracture Risk in Users of Oral Glucocorticoids
NEW YORK (Reuters Health)—Early oral bisphosphonate use is associated with a lower risk of fractures among oral-glucocorticoid users, researchers from Canada report. Bisphosphonates are commonly used for glucocorticoid-induced osteoporosis, but their efficacy has been established only in primary osteoporosis, where the mechanism of action of bone loss differs from that seen with glucocorticoid use. Dr….
Medication Adherence for Osteoporosis Prevention
In a new study, patients taking denosumab had greater treatment adherence over two years than patients on alendronate and other anti-osteoporosis agents…
Switching from Bisphosphonates to Teriparatide May Improve BMD in Women with RA
NEW YORK (Reuters Health)—Switching women with rheumatoid arthritis (RA) from oral bisphosphonates to teriparatide increases bone mineral density (BMD) and trabecular bone score, according to a new report. Researchers in Japan conducted an 18-month observational study of more than 175 women with RA (mean age: 66) who remained on oral bisphosphonates, switched to denosumab (DMAb),…
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