Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
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Opioid Use Common Even After Minor Surgery
(Reuters Health)—The risk that surgery patients will become chronic opioid users may be similar after minor procedures or major operations, a U.S. study suggests. Three to six months after surgery, new chronic opioid use was about 5.9% with minor operations and 6.5% with major surgery, the study found. The rate was just 0.4% in people…
Use Time Component When Coding Counseling, Coordination of Care Visits
Although there are seven components for the levels of evaluation and management (E/M) services, most encounter levels are coded on the basis of the history, examination and medical decision making (MDM), which are the key components extracted from documentation in the medical record. However, when counseling and coordination of care for a patient are the…
Weakness, Fatigue Can Signal Underlying Rheumatologic Disease
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Trump Administration Issues Final Rule on Stricter Obamacare Enrollment
WASHINGTON (Reuters)—The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance, healthcare experts say. It could also raise out-of-pocket medical expenses, the experts say,…
The Risks of Opana Extended Release
In March, an FDA advisory committee voted that the risks of Opana ER to public health outweigh its benefits as a chronic pain treatment…
U.S. & Europe Evaluate Abaloparatide Injection & Europe Approves Marketing Baricitinib for RA
Injectable abaloparatide is being evaluated in the U.S. and Europe to treat postmenopausal women with osteoporosis…
CORC: The Uncomfortable Move from Fee for Service to Value
ACR members are spread out across the U.S., but we all work in the same place: the land of fee for service. FFS, as it’s known to policy nerds, poses certain problems for cognitive subspecialists like rheumatologists. For instance, much of the work we do—calling providers and patients, coordinating care after hours—often isn’t compensated. And…
Sirukumab Promising for RA
In a clinical trial, RA patients on sirukumab experienced decreased disease activity and improved physical function…
Do You Have What It Takes to Be an Educator?
Two rheumatologists share why they became educators, the challenges they face and what keeps them teaching young physicians…
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