SAN FRANCISCO—“We haven’t made a lot of progress in ensuring the early diagnosis of spondyloarthritis,” said Walter Maksymowych, MD, FRCP, professor of medicine in the Division of Rheumatology at the University of Alberta and chief medical officer at CaRE (Canadian Research and Education) Arthritis, both in Edmonton. Speaking at the California Rheumatology Alliance 2016 Medical…
Lupus Treatment Advances Lag Behind Other Rheumatic Diseases
SAN FRANCISCO—In a presentation on advances in the treatment of systemic lupus erythematosus (SLE) at the California Rheumatology Alliance 2016 Medical & Scientific Meeting in May, Maria Dall’Era, MD, director of the Lupus Clinic and Rheumatology Clinical Research Center at the University of California, San Francisco, discussed the range of treatments that have been identified…
New Criteria Released for Macrophage Activation Syndrome in Juvenile Idiopathic Arthritis
Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…
The ACR Participates in Workgroup to Aid Transition of Pediatric Patients to Adult Healthcare Settings
Recognizing that gaps often occur in the transition process for young adults as they transition from pediatric to adult healthcare, in particular for youth with special healthcare needs, the American College of Physicians’ (ACP’s) Council of Subspecialty Societies (CSS), of which the ACR is a member, initiated a project and engaged several medical specialty organizations…
Rheumatology Coding Answer: Level 3 Established Patient Evaluation and Management Office Visit
Take the challenge. CPT: 99213 Diagnosis Codes: M05.79, M17.12, Z79.1, Z79.899 Rationale to code this encounter as 99213: History—The history of present illness was extended. The review of systems was comprehensive, and two of the three past, family and social history were documented. This makes the history level comprehensive. Eight systems were examined. This makes…
Rheumatology Coding Question: Level 3 Established Patient Evaluation and Management Office Visit
Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….
Biochemical Insights into Progeria Syndrome Identify Bisphosphonates, Statins as Possible Candidate Drugs to Halt Aging
Can We Stay Forever Young? May your heart always be joyful And may your song always be sung May you stay forever young Forever Young —Bob Dylan Beneath the rubric of orphan diseases reside some rare conditions and others that are extraordinarily uncommon. These are the diseases that most physicians either never to get to…
Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…
Rheumatology Coding Corner Answer: Physical Examination with Infliximab Infusion
Take the challenge. CPT: 99214-25, 96413, 96415 x 1, J1745 x 35 ICD-10: M07.68, K51.80 Billing Overview It is appropriate to bill for an E/M visit for this day of service along with the infusion procedure. Modifier 25 should be appended to the E/M, indicating that the patient received a significant, separately identifiable E/M service…
Rheumatology Coding Corner Question: Physical Examination with Infliximab Infusion
A 12-year-old male established patient with inflammatory bowel disease with associated juvenile spondyloarthropathy returns to the office for a follow-up visit for his infliximab infusion. The patient reports moderate pain in his right hip after walking for extended periods of time or after sports activities. He denies any other joint pain and denies any joint…
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