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

First Biosimilar Drugs Approved in U.S., Canada

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The first biosmilar products have been approved in the U.S. and Canada, following Europe’s early lead. Canada approved its first biosimilar monoclonal antibody (mAb) therapy, known as Inflectra (infliximab), on March 30, 2015.1 In Canada, biosimilars are being called subsequent entry biologic (SEB) agents. Inflectra is approved for treating patients with rheumatoid arthritis (RA), ankylosing…

Rehabilitation, Therapy Goals for Scleroderma, Acroosteolysis

Lauren Tarsi and Marie B. Corkery, PT, DPT, MHS, FAAOMPT  |  

Scleroderma is a rare rheumatologic auto­immune disease that affects the skin and can also affect other organs. Due to excess formation of scar tissue, blood flow to the extremities is decreased, primarily to the hands, and tissues often become hypoxic, resulting in sclerodactyly and proximal skin involvement.2 The incidence of scleroderma in the U.S. is…

Plaquenil: From Malaria Treatment to Managing Lupus, RA

Charles Radis, DO  |  

In 1984, I wrote my first prescription for the antimalarial drug, hydroxychloroquine (Plaquenil), for a 28-year-old woman with SLE. She was considerably overweight, with inflammatory arthritis and a photosensitive rash, and I worried that oral corticosteroids would tip her over into diabetes. I presented the case to my attending, Steven Malawista, MD, at the Yale…

Rheumatology Coding Corner Question: Knee Osteoarthritis

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Incident-to Billing Case Scenario A 51-year-old female patient returns for a follow-up visit with a physician assistant (PA) for unilateral primary osteoarthritis of her right knee. She had an intraarticular corticosteroid injection of her right knee six weeks prior to her visit. She reports significant improvement in her knee pain and stiffness, and states the…

Rheumatology Coding Corner Answer: Knee Osteoarthritis

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Diagnoses: ICD-9 715.16, 528.02, E943.8 ICD-10 M17.11, K12.32, T39.395A This was an established patient visit with a new diagnosis. Because the PA sought out the physician to address the new problem and document the assessment and treatment, the visit can still be billed as incident-to. Note: The physician initiated the plan of care for treatment…

Diagnostic Imaging in Patient with Elbow Pain: History

Veronika Sharp, MD, Midori Jane Nishio, MD, and Lily Kao, MD  |  

Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History These images were taken of an 85-year-old female with a one-year…

Diagnostic Imaging in Patient with Elbow Pain: Findings

Veronika Sharp, MD, Midori Jane Nishio, MD, & Lily Kao, MD  |  

View the question. Transverse (see Figure 1) and longitudinal (see Figure 2) ultrasound images show an anechoic collection (asterisks), which surrounds the distal biceps tendon (b). The collection is compressible (not shown here). The biceps tendon is heterogeneous in echo texture, with fiber dropouts and an irregular border (in the transverse view). The elbow joint…

Health Data Breaches on the Rise

Kathryn Doyle (Reuters Health)  |  

Large-scale health data breaches reported by doctors and health plans have been rising steadily, a new report shows. From 2010 to 2013, nearly 1000 large breaches affected more than 29 million individual health records, and more than half resulted from theft or loss of laptops, thumb drives and paper records, according to researchers with access…