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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Coding Corner Questions: Navigating Medicare’s Online Resources

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A practice receives an overpayment request from the Centers for Medicare & Medicaid Services (CMS) for not meeting medical necessity related to a biologic infusion. In which instructional guideline can the coding and billing staff find the necessary information on the CMS website to handle this request? Internet-only manuals National Correct Coding Initiative Medically Unlikely…

How to Navigate & Manage Insurance Overpayments

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Insurance overpayments can occur in a practice for a variety of reasons. An insurer may simply make a mistake by paying a provider more than the contracted amount for a service or pay for a service that is not covered under the patient’s insurance plan. Whatever the reason, overpayments can and will create headaches for…

The ARP Aids Rheumatology Workforce Expansion Via Online Education

Benjamin J. Smith, PA-C, DFAAPA, Sonam Kiwalkar, MD, & Aileen Ledingham, PT, PhD, on behalf of the ARP eLearning subcommittee  |  

The Advanced Rheumatology Course (ARC) carries the distinction of being the first online educational product of the ACR/ARP. In the early 2000s, members of the College thoughtfully considered action needed to efficiently prepare health professionals looking to enter the rheumatology workforce. A decision was made to create online educational products with the specific target audience…

Leading Boldly: Transforming Rheumatology Campaign Makes Progress

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In 2018, the Rheumatology Research Foundation embarked on its third and most ambitious fundraising campaign, Leading Boldly: Transforming Rheumatology, with a goal of raising $75 million over five years. The campaign supports Foundation programs to recruit the best and brightest into the field, train rheumatology professionals at all career stages and support investigators conducting research…

Dr. Jonathan Paramo: Rheumatologist & Parrot Enthusiast

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Excluding the years he spent in medical school, Jonathan Paramo, MD, has always kept birds as pets. As an animal lover,  he believes he shares a special chemistry with birds, specifically any species of parrots. When he’s around them, he says he experiences “a special feeling.” “There are cat lovers and dog lovers, but you…

ACR Survey Seeks to Better Define Conflicts of Interest

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Recognizing that situations involving ties with the pharmaceutical industry and conflicts of interest are often not black and white, the ACR’s Committee on Ethics and Conflict of Interest has collected feedback on four ethically challenging scenarios to gauge how rheumatology providers think about them. The survey generated responses that were often mixed, showing that when…

Figures 1 & 2: Transverse and longitudinal ultrasound views, respectively, of the left posterior knee, revealing a cystic mass with heterogeneous internal echotexture and no stalk.

Ultrasound Aids Diagnosis of Man with Knee Pain & Swelling

Mark H. Greenberg, MD, RMSK, RhMSUS, Prem Patel, Elijah Mitcham, MD, James W. Fant Jr., MD, & Frank R. Voss, MD  |  

A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteo­arthritis three years before. In addition to the knee pain, the patient described several years of…

Case Report: Rheumatoid Arthritis-Associated Restrictive Pericarditis

Scott Rodriguez, MD, Kenton Powell, MD, & Daniel Albert, MD  |  

Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects approximately 1% of the adult population, and involvement of extra-articular tissue occurs in approximately 40% of patients over their lifetimes.1 RA-associated pericardial disease is an uncommon complication, and surgery is the only definitive therapy—according to current literature. In this report, we present the case of…

Survey Sheds Light on Physician Retirement

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According to a survey commissioned by CompHealth, doctors work longer than the average American, intending to retire at age 68.1 Eventually, most physicians do decide to pull the plug on their careers. Questions about when to retire and what happens next are important to answer. “The primary question to ask yourself is, ‘Do I still…

Case Report: Tumor Treatment Unleashes Autoimmunity

Shuwei Wang, MD, Gulam A. Manji, MD, PhD, & Anca D. Askanase, MD  |  

Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…