Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options, others have few or only off-label options. This series, Rheumatology Drugs at a Glance, provides streamlined information on the administration of biologic, biosimilar and other medications used to…
My nephew is an addict. These words do not come easily to me, but I have come to accept them as true. In retrospect, I should have recognized the telltale signs: He stopped picking up the phone when I call. He disappears and then re-emerges hours later, seemingly having done nothing. He has lost interest…
We all know words can be powerful. They often resonate with several levels of meaning, enriching our understanding and broadening our perspective. Take the word promise, for example. It implies responsibility, as in, “We promise to do it.” It is also imbued with hope, as in “This idea has great promise.” At the ACR we…
In March 1987, Mark Andrejeski moved from Columbus, Ohio, to Atlanta to lead a brand-new organization: the American Rheumatism Association (ARA). The professional association of rheumatologists had separated from the Arthritis Foundation 15 months earlier. “Initially, I was just trying to make sure the organization survived,” says Mr. Andrejeski, who studied business management and economics…
The advent of quality-based healthcare, such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), requires rheumatology professionals to demonstrate their practice is based on interventions supported by the best available evidence and that their practice, in turn, provides quality care. These requirements have increased the need for methods to measure and quantify…
SEATTLE—At the first regional vasculitis patient conference ever held in the Pacific Northwest, a panoramic view of Mt. Rainier on a clear January morning set the tone for a day of optimistic talks about recent successes against the various forms of blood vessel inflammation. One attendee at the Jan. 12 conference, sponsored by the Vasculitis…
Idiopathic inflammatory myopathies are heterogenous, acquired immune-mediated muscle diseases. Over the past decade, immune-mediated necrotizing myopathy has been recognized as a subcategory of idiopathic inflammatory myopathy characterized by myofiber necrosis in the absence of prominent inflammatory cells.1 Autoantibodies against signal recognition particle (SRP) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) are thought to be associated with the…
CHICAGO—At Hot Topics in Myositis, a session at the 2018 ACR/ARHP Annual Meeting, three experts discussed new classification criteria for idiopathic inflammatory myopathies (IIM) and offered practical primers on overlap myositis conditions and inclusion body myositis (IBM). New Myositis Classification Criteria After a 10-year development process, the new EULAR/ACR Classification Criteria for Adult and Juvenile…
CHICAGO—Rheumatology healthcare providers should embrace collaborative approaches to manage chronic musculoskeletal pain in older adult patients, including models of care that involve multiple providers, patients and their caregivers. That was the message delivered by two speakers in the Interdisciplinary Management of Chronic Musculoskeletal Pain in Older Adults session at the 2018 ACR/ARHP Annual Meeting. “As…
CHICAGO—Medical practice consultant Owen Dahl, MBA, LFACHE, CHBC, looked out at the rheumatology practice managers and physicians, sitting around tables with white tablecloths, and asked what seemed like a simple question: “How many of you have a strategic plan?” he asked. A single hand was raised. “One? How do you know where to go tomorrow…
A 60-year-old woman with a six-month history of retroperitoneal fibrosis transfers her care to you. She initially presented with severe bilateral flank pain radiating to the abdomen and chest. A computerized tomography (CT) angiogram of the abdomen demonstrated an infrarenal abdominal aortic aneurysm surrounded by a thick inflammatory rind entangling the left renal vein and…
In November 2017, Brit Adler, MD, an instructor in the Division of Rheumatology at Johns Hopkins University, Baltimore, was traveling across a glacier in the Cordillera Blanca mountain range in Peru. At nearly 15,000 feet high, the hikers in the caravan were secured to each other by ropes secured to harnesses. At that altitude, no…
The FDA has issued a boxed warning for febuxostat after a safety study found an increased risk of heart-related and other death in RA patients…
The FDA has approved a single-press, self-injection device for a 100-mg dose of guselkumab for adults with moderate to severe plaque psoriasis…
The workforce shortage in rheumatology is a critical issue the Rheumatology Research Foundation is tackling. The number of patients with rheumatic disease is growing exponentially, and that means more health professionals and innovative approaches are needed to ensure rheumatology practices are set up to offer the best care. In 2018, the ARP released a core…
As a physician, I am an advocate. I am an advocate for my patients individually and collectively, and I am an advocate for my field: pediatric rheumatology. My own experiences as a patient drive me to integrate my patients’ perspectives into my medical decision making, and although my academic training has prepared me to best…
The ACR welcomes David Karp, MD, PhD, UT Southwestern, Dallas, to serve as ACR treasurer for 2019. As a returning member of the Executive Committee, Dr. Karp brings a breadth of ACR volunteer experience. His past roles have included serving as the Rheumatology Research Foundation president, as well as an ACR board member.
The evaluation and management (E/M) code set in the American Medical Association’s Current Procedural Terminology (CPT) book lists descriptors, as well as typical times for patient visits. These times are averages of how long it takes a physician to complete all components of a visit at each level. Because the specific times identified in the…
A 66-year-old female patient returns for a second infusion of rituximab for her diagnosis of rheumatoid arthritis in multiple sites. She is rheumatoid factor positive. She says the pain in her knees, elbows and neck has slightly improved. She rates the severity of her pain at a 7 on a 10-point scale, which is an…
Take the challenge. CPT Codes: 96413, 96415 x 3, J9312 x 5, 96375, J2920 Diagnoses: M05.79 Coding Rationale As of Jan. 1, 2019, the Healthcare Common Procedure Coding System (HCPCS) code for rituximab was changed from J9310 rituximab 100 mg, to the new HCPCS code J9312 (injection, rituximab, 100 mg). According to a Verywell Health…