Complement can deposit in various tissues, and previous studies have associated complement deposition with an increased risk for all-cause mortality and stroke. Now, new research underscores the relationship between rheumatic disease, the complement system and cardiovascular disease. In particular, inflammatory rheumatic disease status appears to be uniquely associated with mononuclear cell infiltrates in the vascular…
Prospects for Treating Patients with Arthritis in African Countries with Few Rheumatologists
At present, the U.S. has approximately 5,000 full-time adult rheumatologists. By the year 2025, that number will decline to roughly 3,600.1 Sounds dire, right? Hold that thought. Question: What country has 99 million people and no adult rheumatologists? Answer: Ethiopia.2 The Nigerian Story And then there is Africa’s most populous country, Nigeria, with roughly 170…
Tips to Help Physicians Understand, Cope, Manage Burnout
Years ago, the Mayo Clinic was exploring effective ways to minimize burnout among the more than 3,000 doctors employed at its three medical and research facilities in Rochester, Minn., Scottsdale, Ariz., and Jacksonville, Fla. One strategy involved inviting physicians to participate in small groups to discuss topics that were fairly ubiquitous among doctors, from medical…
Infection Rates for Patients with SLE on Immunosuppressive Drugs
A comparison study of the serious infection burden among patients with lupus found no major differences in patients treated with three separate immunosuppressive drug regimens. Given that serious infections are among the leading causes of hospitalizations and death in patients with systemic lupus erythematosus (SLE), researchers investigated whether the incident rates differed in patients who…
Documentation Guidelines for Proper Medical Decision Making
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
Rheumatology Coding Corner Question: Infusion Services for Skilled Nursing Facility Patient
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
Tight RA Control Via Telemedicine Noninferior to Conventional Clinic Visits
NEW YORK (Reuters Health—Telemedicine follow up based on patient-reported outcome (PRO) is noninferior to conventional outpatient care for tight control of disease activity in rheumatoid arthritis (RA) patients with low disease activity or remission, new findings show. “Even though patients in the [telemedicine] follow-up groups requested more acute visits, they over-all had a more than…
Tips for Managing Young Adult Rheumatology Patients
Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…
Demand for Arthritis Care in America Outstrips Supply of Practicing Rheumatologists
May is National Arthritis Awareness Month. The ACR is committed to ensuring that arthritis and rheumatologic diseases are at the forefront of public awareness—and that better, safer treatments reach Americans in need. Fortunately, the federal government is also doing its part and has just released a major report on the national impact of arthritis. A…
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