Osteoarthritis and Bone Disorders

Pulse-Echo Ultrasound Useful for Osteoporosis Screening

Will Boggs, MD | November 29, 2015

NEW YORK (Reuters Health)—Pulse-echo ultrasound is a useful method for point-of-care osteoporosis screening, researchers from Finland report. “To effectively increase diagnostic coverage, this kind of device should be in every primary or occupational healthcare unit,” Dr. Janne P. Karjalainen from the University of Eastern Finland in Kuopio tells Reuters Health by email. Currently, osteoporosis is…

Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis

From the College | November 17, 2015

CPT: 99213, 73500-RT, 73500-LT ICD-10: M16.52 This E/M service entailed: The history is detailed; The examination is expanded problem focused; and The medical decision making is of low complexity. The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip. M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis…

Rheumatology Coding Corner Question: Coding for Post-Traumatic Osteoarthritis

From the College | November 17, 2015

Post-Traumatic OA A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised…

Bone Turnover Markers Show Link to Iliac Histomorphometry in Older Women

Reuters Staff | November 12, 2015

NEW YORK (Reuters Health)—Although histomorphometry of iliac bone gives precise results, bone turnover markers provide a better reflection of the overall skeleton in untreated postmenopausal osteoporotic women, according to French researchers. Bone histomorphometry allows study of bone remodeling at the basic structural unit level, Dr. Pascale Chavassieux and colleagues at the University of Lyon note…

Zimmer Wins First U.S. Trial over NexGen Flex Knee Devices

Jessica Dye | November 10, 2015

(Reuters)—Indiana-based medical device manufacturer Zimmer Biomet Holdings Inc. on Friday was cleared of liability in the first of more than 900 U.S. lawsuits to go to trial over claims that its NexGen Flex knee replacements were prone to painful, motion-impairing loosening. Following a three-week trial in the U.S. District Court for the Northern District of…

Low-Grade Inflammation in Symptomatic Knee OA

Arthritis & Rheumatology | October 29, 2015

Although osteoarthritis (OA) was formerly considered a non-inflammatory joint disease, it’s now well-appreciated that inflammatory mediators, such as PGE2 and IL-1β, are produced by osteoarthritic joint tissues and can be used to identify patients with symptomatic knee OA. A peripheral blood leukocyte inflammatory transcriptome identifies a subset of symptomatic knee OA patients at higher risk for radiographic progression and may reflect persistent low-grade joint inflammation…

BMI Feasible As Pre-Screening Tool for Osteoporosis in Women

Larry Hand | October 24, 2015

NEW YORK (Reuters Health)—A body mass index (BMI) of less than 28 alone may be a tool to prescreen younger postmenopausal women for osteoporosis, according to a new study. “For young postmenopausal white women aged 50–64, current prescreening modalities identifying candidates for DXA (dual-energy X-ray absorptiometry) scan … are not performing better than BMI alone,”…

Knee Replacement Surgery Works, but So Can Nonsurgical Techniques

Gene Emery | October 23, 2015

(Reuters Health)—Total knee replacement can usually relieve pain and improve function, but a nonsurgical regimen can also be effective in some people without posing the complication risks of surgery, according to a new study. The study found that while 85% of patients who underwent surgery showed clinically-significant improvement after one year, so did 67% assigned…

Rheumatology Coding Corner Answer: Coding for a Knee Injection

From the College | October 14, 2015

Take the challenge. CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral pri- mary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in…

Rheumatology Coding Corner Question: Coding for a Knee Injection

From the College | October 14, 2015

Coding for a Knee Injection A 68-year-old female patient with primary osteoarthritis of the left knee returns to the office for her scheduled hyaluronan injection. The patient reports that her knee is a little tender, but on a scale of 1–10, it is a 4. She is stiff in the morning for 10–20 minutes. The…