A 65-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left hand, elbow and neck that is persistent since her last visit. The pain is considerably worse in the morning. She denies any fevers, cough or dyspnea. The…
Rheumatology Coding Corner Answer: Trigger Point Injections for Fibromyalgia
Take the challenge. CPT codes: 99213-25, 20553, 73120/LT Diagnosis: ICD-9 7291 ICD-10 M79.7 Coding for trigger-point injections continues to create a lot of confusion on proper coding guidelines. Keep in mind, two CPT4 codes can be used for trigger-point procedures: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Single or multiple trigger…
Disease Management Programs Help Patients Cope with Chronic Diseases
For patients living with a chronic disease, such as rheumatoid arthritis or osteoarthritis, learning to manage and cope with the myriad adverse symptoms that accompany these diseases is key to improving quality of life and helping reduce the cost burden of these illnesses on the healthcare system. One important way rheumatologists can help is by…
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Redefined
A report from the Institute of Medicine that gives new diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and recommends a new name for the disorder received mixed reviews from rheumatologists and other physicians.1 “Diagnosing ME/CFS often is a challenge … the new diagnostic criteria will make it easier for clinicians to recognize and accurately…
Glucocorticoid Use for Rheumatoid Arthritis Still Sparks Debate
Glucocorticoids: The Debate Continues Déjà vu … In past decades, rheumatologists have seen, heard, practiced and taught much of what has been argued in the “ongoing debate” on the use of glucocorticoids (GCs) in the management of rheumatoid arthritis (RA).1 It is heartening to note that eminent professors have stuck to their premise all these…
Restoration of Sleep Physiology vs. Sedation for Sleep Disorders, Fibromyalgia
Sleep disturbance is an important medical problem, requiring intervention, not simply to reduce latency to its onset, but to ensure achievement of the depth of sleep that has been documented to restore homeostasis and prevent the falls that are responsible for so much morbidity and mortality.1 Sleep disturbance is present in 50% of people over…
Naive B Cells Activate & Expand During Lupus Flares
New research published in May indicates a possible connection between B cells and the occurrence of systemic lupus erythematosus symptoms.
Clinical Trials Ongoing for Brodalumab
Brodalumab, an interleukin (IL) 17 inhibitor, is currently in early clinical trials (Phase 1b and Phase 2) for a number of different autoimmune diseases.1 Amgen recently terminated its co-development and commercialization agreement with AstraZeneca for the brodalumab investigational program in trials for moderate to severe plaque psoriasis, psoriatic arthritis and axial spondyloarthritis. Amgen’s decision to…
Weight Loss May Predict Early Death in RA Patients
According to a new study, patients with RA experiencing weight loss unrelated to exercise may be at risk of premature death.
Isometric Exercise May Immediately Reduce Pain of Patellar Tendinopathy
NEW YORK (Reuters Health)—Volleyball players with patellar tendinopathy reported an immediate easing of their pain after isometric exercise, and the effect persisted for 45 minutes after the intervention, a new study has found. In contrast, isotonic exercise appeared to diminish the athletes’ pain to a lesser degree, and the effect did not last at the…
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