Take the challenge. CPT codes: 99214-25, 20610-RT, J1030x1 Diagnoses: M05.79, M25.561 This is an established patient visit with an established diagnosis, along with a new diagnosis, which would have to be billed under the PA’s National Provider Number (NPI) and reimbursed at 85% of the fee schedule. Keep in mind that to qualify as an…
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In Memoriam: Dr. H. Ralph Schumacher Jr.
Our esteemed colleague, H. Ralph Schumacher Jr., MD, professor emeritus and former acting chief of rheumatology at the University of Pennsylvania School of Medicine, and section chief of rheumatology at the VA Medical Center in Philadelphia, died at his home on July 30 from complications of amyotrophic lateral sclerosis. Dr. Schumacher was a true giant…
TNF Stabilizes Inflammatory RNA in Synoviocytes
A recent study has helped researchers gain insight into the genome-wide regulation of mRNA stability in RA fibroblast-like synoviocytes (FLS). Chronic exposure of FLS to tumor necrosis factor appears to increase mRNA stability, enhancing the expression of inflammatory genes and the perpetuation of synovitis…
Rheumatology Drug Updates: Opana ER Painkiller Pulled from U.S. Market; Upadacitinib to Treat RA, and More
Opana ER Pulled from U.S. Market Last month, the U.S. Food and Drug Administration (FDA) asked Endo Pharmaceuticals to remove oxymorphone hydrochloride extended release (Opana ER) from the U.S. market due to public health consequences related to abuse. The agency has concerns that the risks presented by the treatment do not outweigh its benefits.1 On…
University of Nebraska Division of Rheumatology and Immunology Makes Education, Clinical Research Top Priorities
When it was created in 1982, the Division of Rheumatology and Immunology at the University of Nebraska Medical Center comprised one-and-a-half rheumatologists: its founder, Lynell W. Klassen, MD, MACR, and Gerald Moore, MD, who later received formal training at the NIH and now serves as senior associate dean for academic affairs. Thirty-five years later, the…
Fellows’ Forum Case Report: Hemophagocytic Lymphohistiocytosis
The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
Aims Review Committee Helps Rheumatology Researchers Craft Grant Proposals
There you are, working steadily away on your next manuscript. The ideas are flowing. You’ve hit your stride. Nothing can stop you now—nothing, that is, except a colleague who shows up at your desk with a 20-page grant proposal. “Do you mind?” he asks. Across academia the problem is the same—too few hours in the…
Gut Microbe, Prevotella copri, Implicated in RA Pathogenesis
New research reinforces the hypothesis that the gut microbiome triggers mucosal and systemic immune responses in patients with rheumatoid arthritis. The research, published in Arthritis & Rheumatology May 2017, found that subgroups of patients with RA have differential immunoglobulin G (IgG) or IgA immune reactivity with Prevotella copri, an intestinal microbe that appears to be…
Effectiveness of Retinoic Acid, Hydroxychloroquine Examined for Hand OA
The Osteoarthritis Research Society International (OARSI) held the 2017 OARSI World Congress in Las Vegas, April 27–30. Below, we report on two of the sessions held. Retinoic Acid & Hand Osteoarthritis Retinoic acid is a vitamin A derivative and hormonal signaling molecule with a role in cartilage and skeletal development. Retinoic acid has complex function,…
Fellows’ Forum Case Report: Tophaceous Bullae
As a manifestation of hyperuricemia, inflammatory bullous lesions have rarely been described in the past century. A more classic presentation of hyperuricemia is acute inflammatory gouty arthritis, characterized by the deposition of monosodium urate crystals. Other complications of chronic untreated hyperuricemia may include polyarticular arthritis, tophus formation and possible chronic destructive lesions of the bone,…
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