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…
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Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA
Sternoclavicular joint involvement has rarely been reported in the context of active rheumatoid arthritis (RA).1 Traditionally, rheumatologists use serial radiographs of hands and feet to diagnose, monitor for progression or evaluate the response to treatment. The sternoclavicular (SC) joint is not a typical joint assessed for RA. However, the fact that it is a diarthrodial…
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…
How to Keep Patient Appointments Running on Time
Nobody likes waiting to see their physician. In fact, a whopping 97% of patients are frustrated by wait times at the doctor’s office, a study has reported.1 That’s a lot of unhappy patients. Fortunately, a practice can do many things to help keep patient appointments on time—beginning with proper scheduling techniques and monitoring patients’ progress…
Patient-Centered Care Model for RA Flares Could Improve Self-Management of Symptoms
A recent trend to incorporate patient-reported outcomes (PROs) in clinical research, and ultimately clinical practice, is a response to the need to better measure and treat what patients truly care about, and adapt to the changing healthcare environment, which increasingly includes patient satisfaction as a key metric for overall quality of care, a metric tied…
The ACR/ARHP Awards Members for Contributions to Rheumatology
San Francisco is known for the Gold Rush, so it’s a particularly fitting place to collect a gold nugget. And so at the 2015 ACR/ARHP Annual Meeting in the Golden Gate City in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and…
Rheumatologist Steven S. Overman Reflects on His Last Day of Practice, Future of Specialty
I am a few weeks post-retirement. Having written thank you notes and completed urgent home projects, I swing in a hammock at our currently fire-threatened cabin north of Winthrop, Wash., and reflect. I feel like a young boy while freely flipping pages of a hand-scribed picture book, The Principles of Uncertainty, by Maira Kalman. She…
Musculoskeletal Ultrasound: A Valuable Tool for Diagnosing Rheumatic Illnesses
Musculoskeletal (MSK) ultrasound is a valuable imaging modality for the practicing rheumatologist and provides an efficient tool with high diagnostic value in the evaluation of patients with musculoskeletal complaints. The use of MSK ultrasound has evolved in the U.S. due to the emergence of less-expensive, portable ultrasound units, which provide high-quality gray-scale and power Doppler…
FOCIS 2015: Metabolism May Affect Immune System’s Reaction to Disease
How the immune system reacts to potential harm, such as lack of oxygen and inflammation, depends greatly on the human body’s metabolic processes and pathways, according to speakers at FOCIS 2015 in San Diego this past June. During a session devoted to metabolism and the immune system, researchers talked about recent studies that shed light…
POP1-Based Treatments May Reduce Inflammation
A recent study analyzed inflammasome response, finding the POP1 PYRIN domain protein acts to decrease excessive inflammatory responses and prevent systemic inflammation. Researchers ultimately developed a drug based on POP1 and found it reduced inflammation in mice…
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