(Reuters Health)—Many patients leaving the hospital don’t understand follow-up care plans because the instructions are tailored to people with higher reading levels and more education, a recent U.S. study suggests. The American Medical Association already recommends that written health information be targeted to a sixth grade audience because nearly half of the U.S. population is…
Rheumatology Coding Corner Answer: Coding for Acute Flare of Idiopathic Gout
Take the challenge. M10.072—Acute gout has an Excludes 1 note of chronic gout (M1A.-). This means that acute gout and chronic gout cannot be coded for the same encounter, as the codes are mutually exclusive. M45.6—The patient is diagnosed with ankylosing spondylitis of the lumbar region. M81.8—Other osteoporosis without current pathological fracture. M79.622—The patient has…
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…
Rheumatology Coding Corner Question: Coding for Acute Flare of Idiopathic Gout
It has been two months since the implementation of ICD-10, so everyone has gotten a feel for the new code set. Let’s see how well you are doing in your diagnosis coding for rheumatology-specific conditions. A 55-year-old female patient presents for a follow-up visit of idiopathic chronic gout of multiple joints without tophi. She complains…
Best Practices for Treating Non-Specific Low Back Pain
Low back pain (LBP) is one of the most common reasons for physician appointments. However, treatment results remain suboptimal, resulting in high rates of chronic pain, narcotic usage, surgery, depression and disability—all at great cost to individuals and the nation. One reason for this is the current practice of grouping all low back pain patients…
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…
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…
Dr. Smith Finds Commonalities in Chess, Rheumatology: Think Ahead, Know Your Patient
James K. Smith, MD, believes in thinking several moves ahead. Consider your opponent. Gauge your strategy. Be aggressive when you need to be. Those are key aspects of his philosophy in rheumatology—and chess. Initiation Dr. Smith’s love of chess started after he had started his family. “I first got involved in the game through my…
Tips for Educating Patients in the Age of Biologics
Patient education has always been at the core of the nursing profession. Nurses pride themselves on being great teachers and patient advocates. When self-injectable biologics were first introduced to the market, one of the main goals was to make patients independent and put them in the driver’s seat of their own care. Yet without a…
New Gout Criteria from the ACR/EULAR Focus on Clinical Trials, Global Standards
Gout affects nearly 4% of American adults, causing joint inflammation, pain and crystal deposits that may lead to bone erosion over time. At least five different classification criteria for gout are used worldwide, creating potential discrepancies in clinical trial enrollment and eventual results. An international panel of investigators collaborated to create new, standardized gout classification…
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