The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
The second annual ACR Division Directors’ Conference took place in Chicago on March 10–11. The conference opened with a presentation on the use of the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry in academic medical centers by Salahuddin “Dino” Kazi, MD, from UT Southwestern Medical Center, and Jinoos Yazdany, MD, MPH, from the University of California…
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
Investigators at Brigham and Women’s Hospital recently discovered a novel subset of peripheral helper T cells (TPH) that drive rheumatoid arthritis (RA) inflammation. Originally published in the February issue of Nature, findings from this study provided bedrock knowledge for developing new RA therapies. Now, with funding from the Rheumatology Research Foundation, investigators are expanding on…
We can’t change the direction of the wind, but we can adjust our sails. The origin of this proverb is unclear. Some citations link it to ancient Hindu philosophers, and others suggest the origin may be closer to home (i.e., Jimmy Dean or Dolly Parton). Nonetheless, the sentiment is apt: We are living in an…
NEW YORK (Reuters Health)—Parkinson’s disease and some autoimmune diseases may have genetic risk factors in common, raising the possibility that the immune system may influence Parkinson’s disease pathogenesis, new research suggests. The study, which analyzed data from genome-wide association studies, “showed a considerable genetic overlap between [Parkinson’s disease] and autoimmune diseases, in particular, type 1…
NEW YORK (Reuters Health—Telemedicine follow up based on patient-reported outcome (PRO) is noninferior to conventional outpatient care for tight control of disease activity in rheumatoid arthritis (RA) patients with low disease activity or remission, new findings show. “Even though patients in the [telemedicine] follow-up groups requested more acute visits, they over-all had a more than…
The P2X7 receptor inflammasome axis may have a role in the pathogenesis of Sjögren’s syndrome and non-Hodgkin’s lymphoma. According to new research, patients with Sjögren’s syndrome who developed non-Hodgkin’s lymphoma had an increased expression of the P2X7R-inflammasome axis and the glandular expression of IL-18, suggesting a possible novel biomarker…
(Reuters)—The U.S. Food and Drug Administration said on Thursday it has asked Endo International to withdraw from the market its long-lasting opioid painkiller Opana ER, sending the company’s shares down as much as 13%. “After careful consideration, the agency is seeking removal based on its concern that the benefits of the drug may no longer…