The Case A 58-year-old patient with knee osteoarthritis has been decreasing her physical activity over the past several years due to painful joints, which has resulted in significant weight gain. At her appointment, you encourage her to engage in more physical activity and eat a well-balanced diet. A few weeks later, the patient returns to…
SAN DIEGO—Exercise, within limits imposed by an individual’s circumstances, is an almost universally beneficial medical therapy. In fact, Teresa J. Brady, PhD, senior behavioral scientist with the federal Centers for Disease Control and Prevention’s Arthritis Program, labeled it “medicine” in a session on exercise at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. Dr. Brady asked whether…
SAN DIEGO—Rheumatologists who treat lupus patients gleaned tips on diagnosis and management of renal disease, painful neuropathies and alopecia at a “Curbside Consults” session held Nov. 6 at the ACR/ARHP Annual Meeting in San Diego. Membranous Lupus Nephritis Patients with refractory membranous lupus nephritis (MLN), or Class V lupus nephritis, face “significant morbidity, most of…
SAN DIEGO—In many regions, rheumatologists are scarce, and shortfalls will only increase. Panelists in the session, Telehealth: Can It Expand the Rheumatology Workforce?, held Nov. 6 during the 2017 ACR/ARHP Annual Meeting, believe technology can help bridge the gap. The more specific term, telemedicine, “refers to clinical care delivered from a distance,” said John A….
SAN DIEGO—It’s no secret: Autoimmune, inflammatory rheumatic disease raises a patient’s risk of cardiovascular disease (CVD). “Inflammation may affect all aspects of the cardiac structure and function,” said Rekha Mankad, MD, FACC, director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minn. Dr. Mankad also oversees a cardio-rheumatology clinic to assess and treat…
Systemic lupus erythematosus (SLE) is an autoimmune-mediated rheumatic disease characterized by multisystem involvement that can cause significant morbidity and mortality. Acute disseminated encephalomyelitis (ADEM) is a rare, fulminant, autoimmune-mediated, demyelinating disease involving the white matter of the central nervous system (CNS), and is considered a manifestation of neuropsychiatric lupus. Few reported cases involve SLE and…
Receiving an RA diagnosis may be emotional and difficult for patients. By engaging the patient in learning about the disease and its treatment options, as well as cultivating a communicative relationship, rheumatologists can truly help a patient take control of their health…
According to a large cohort study of pediatric patients, rituximab use is on the rise in the treatment of children diagnosed with vasculitis. Treatment with cyclophosphamide remains common, but it’s beginning to wane. Dialysis and mechanical ventilation also remain common, the study indicates. The retrospective study of hospitalized children in the U.S. included the largest…
Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…
1. A 68-year-old new female patient has an appointment to see the rheumatologist in four days. The patient has her medical records sent over from her primary care physician, neurologist and endocrinologist for the rheumatologist to review prior to the visit. Upon receipt, the rheumatologist spends 55 minutes reviewing the records and making notes. Can…