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Gout and Crystalline Arthritis

Rheumatology Coding Corner Answer: Gout Visit for Established Patient

From the College  |  October 10, 2016

CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established out­patient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…

Rheumatology Coding Corner Question: Gout Visit for Established Patient

From the College  |  October 10, 2016

A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…

Gout Treatment & Care Remain Suboptimal

Lara C. Pullen, PhD  |  September 12, 2016

A recent analysis compared the care of patients with RA with that received by patients with gout, finding that hospitalization and costs for patients with gout have increased, but both are decreasing for patients with RA. Unlike RA, significant advances in treatment have not been made for gout, despite its increasing prevalence, and patients may land in the hospital unnecessarily…

New Research into Rheumatoid Arthritis, Gout Includes Updates on Methotrexate, Biologics, Ultrasound

Thomas R. Collins  |  September 8, 2016

LONDON—From optimizing responses to methotrexate, to the efficacy of biologics, to the need for imaging in assessing remission, the literature, as ever, has been lively with explorations of pressing topics in the treatment and management of rheumatoid arthritis. Josef Smolen, MD, chair of rheumatology at the Medical University of Vienna, reviewed many of the highlights…

Blacks, Asians at Higher Risk for Allopurinol-Related Skin Reactions

Deborah Levenson  |  September 8, 2016

Be careful when prescribing allo­purinol to black and Asian gout patients, a study newly advises. Black and Asian patients who take this ubiquitous, more-than-40-year-old medication are at much higher risk of certain serious skin reactions than are Caucasians or Hispanics. Compared with Caucasians, blacks who take allopurinol to lower blood urate levels have an increased…

Treatment Options for Severe Refractory Gout When Pegloticase Fails

Diana M. Girnita, MD, PhD, Cody Lee, MD, & Christine Chhakchhuak, MD  |  August 12, 2016

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…

Treating Asymptomatic Hyperuricemia Could Lower Risk of Developing Chronic Conditions

Martin Garber, DO  |  August 12, 2016

When uric acid becomes elevated in the human body, a variety of problems can develop, most notably gout—a painful, inflammatory arthritis caused by uric acid crystal deposition in joints. Chronically elevated uric acid can also lead to painful kidney stones. The majority of patients found to have hyperuricemia, however, never go on to develop gout…

Patients with Gout May Not Understand Serum Urate Goals & Treatments

Richard Quinn  |  July 1, 2016

New research has found that a minority of gout patients understands the importance of their serum urate goals. Ted Mikuls, MD, MSPH, says the study shines a light on a gap in patient education providers can address…

Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2

From the College  |  February 17, 2016

A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…

Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2

From the College  |  February 17, 2016

Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…

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