As a practicing rheumatologist, I have experienced the increasing payer and government involvement shaping our evolving healthcare system. New payment models, changes in health insurance coverage, the federal mandate for the adoption of electronic health records and the implementation of ICD-10 are recent changes that have rocked our world. Our patients are also paying the…
Improve RA Care with Vitamin D
Background Autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematous, occur when the body attacks its own tissue because it cannot differentiate between self and non-self. This is mainly through deregulation of the immune system. Vitamin D has been known to play a critical role in bone mineralization and bone health. Activated vitamin…
Celiac Disease in Pediatric Patients
A retrospective study shows that some patients presenting for pediatric rheumatology evaluation test positive for celiac disease—some without showing any gastrointestinal manifestations. Treatment includes a gluten-free diet…
Legalities of Telemedicine
A brief has been filed with the U.S. Supreme Court that, if the court decides to hear the case, could have wide-ranging implications for online medical care and the limits of a physician’s First Amendment right to free speech. Medical Advice Via e-Mail Institute for Justice Senior Attorney Jeff Rowes filed the brief at the…
Rheumatology Coding Corner Answer: Coding for a Knee Injection
Take the challenge. CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral pri- mary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in…
Rheumatology Coding Corner Question: Coding for a Knee Injection
Coding for a Knee Injection A 68-year-old female patient with primary osteoarthritis of the left knee returns to the office for her scheduled hyaluronan injection. The patient reports that her knee is a little tender, but on a scale of 1–10, it is a 4. She is stiff in the morning for 10–20 minutes. The…
Documentation: A Key Factor of Risk Adjustment
In an age of constant change and regulations, one thing remains the same in coding and billing: If it’s not documented, it wasn’t done. This is the main rule for documentation. Good documentation is and always has been the foundation of accurately capturing a provider’s work and the patient’s condition, management and treatment. Introduced by…
Meditation May Help Prevent Physician Burnout
Physician burnout is high and climbing. A 2015 report published by Medscape showed that nearly half (46%) of physicians surveyed responded that they were experiencing burnout; that number is up from 39.8% reported in a similar survey in 2013.1 These physicians experience the tell-tale signs of burnout: loss of enthusiasm for work (or emotional exhaustion),…
Survey: Patient-Doctor Relationship Can Positively Affect RA Management
A new survey of more than 3,600 adults living with rheumatoid arthritis (RA) shows that a patient’s perception of their disease and treatment, as well as their relationship with their healthcare professional, can positively impact the management of their disease. The RA NarRAtive survey, created and sponsored by Pfizer, is part of an international initiative…
Tips on Offering Constructive Criticism to Employees
Telling an employee that they need to improve does not conjure up warm, fuzzy feelings. In fact, many employers dread it and may get gun shy. After all, an employee could take it the wrong way, and the constructive criticism could be ill received. “This is a legitimate fear, because many people have given constructive…
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