Take the challenge. Correct Answer: CPT: 99204 ICD-10: I73.00 Coding Rationale This is a new patient, outpatient visit for a self-referred patient. There is no formal consultation request from another physician; therefore, the encounter does not meet criteria for a consultation. This encounter is coded as 99204 because it included: Comprehensive history—Extended history of the…
Rheumatology Coding Corner Question: Level 4 New Patient Visit
A 32-year-old female patient comes in for an initial visit. She is self-referred and complains of pain, numbness and color changes in her fingers when exposed to cold. The patient reports that her right distal index finger, left distal index finger and fourth right finger turn white and blue with pain and numbness when exposed…
Transition to ICD-10 Diagnostic Code Set Successful for Most Rheumatology Practices
It has been 11 months since the implementation of the ICD-10 diagnostic code set on Oct. 1, 2015, a change from the previous ICD-9. Most practices can probably attest that the transition came and went without the predicted doomsday outcome: Claims were still processed, the confused alphanumeric coding was applied, and patients were not deprived…
ACR Seeks Advisors for AMA/Specialty Society RUC and CPT Committee
The ACR is searching for practicing physicians interested in coding and reimbursement issues to represent the ACR on the AMA/Specialty Society Relative Value Scale Update Committee (RUC) and Current Procedural Terminology (CPT) Committee. The RUC and CPT Committee comprise physicians representing the national medical specialty societies who advise the CPT Editorial Panel on matters concerning…
When Rheumatologists Are a Patient’s Second or Third Choice for Medical Opinion
Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…
Treatment Options for Severe Refractory Gout When Pegloticase Fails
Pegloticase is a new alternative therapy for patients with severe, refractory gout unresponsive to other urate-lowering agents. The goal of this therapy is to reduce disease burden, tophi size and frequency of flares and to improve quality of life when other treatments have failed. Persistent lowering of plasma uric acid (PUA) to less than 6…
E-Health, Telemedicine Pose Challenges, Offer Benefits for Patients with Arthritis
A 52-year-old woman comes to the office complaining of a two-month history of pain and swelling in the small joints of her hands, feet and knees. She says, “Doctor, I’ve been searching the Internet, and I think I have rheumatoid arthritis. I have some questions for you.” The healthcare system in the U.S. is changing…
Resarch Into IgG4-Related Diseases Expands Knowledge Base, Leads to Effective Treatments
CHICAGO—Researchers have come to know a great deal about IgG4-related disease in a short amount of time, leading to effective treatments with the prospect for more, an expert said at the 2016 State-of-the-Art Clinical Symposium. “One of the most exciting things for me is how quickly we’ve been able to move in understanding this disease,”…
Treatment Challenges, Uncertainty Abound with IgA Vasculitis
CHICAGO—Diagnosing and treating IgA vasculitis—leukocytoclastic vasculitis involving deposits of IgA1 deposits on the walls of small vessels—is rife with uncertainties, outright unknowns and treatment challenges, an expert on the disease said at the ACR’s 2016 State-of-the-Art Clinical Symposium. Alexandra Villa-Forte, MD, MPH, staff physician at Cleveland Clinic’s Center for Vasculitis Care and Research, said IgA…
Heterogeneity of Vasculitis Challenges Rheumatologists
SAN FRANCISCO—The heterogeneity of systemic vasculitis, a set of diseases characterized by inflammation of blood vessel walls, presents rheumatologists with diagnostic and treatment challenges, said Sharon A. Chung, MD, MAS, director of the University of California, San Francisco Vasculitis Clinic, at the California Rheumatology Alliance 2016 Scientific & Medical Meeting in May. She outlined emerging…
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