Nationally, opioid use and addiction are drawing increased scrutiny. An increase in the number of overdoses and addiction to heroin and prescription pain relievers in the past decade has been attributed in part to increased prescribing of opioids for the treatment of pain by physicians. National trends suggest the rate of opioid prescribing plateaued in…
Search results for: tramadol
Rheumatology Coding Corner Question: Coding for Incident-to Services
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
International Task Force Recommends Intra-articular Hyaluronic Acid for Knee OA
An international task force convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommends systematic repeated intra-articular hyaluronic acid (HA) injections as second-line treatment for patients with knee osteoarthritis (OA). This is the first time a group of experts has made this recommendation, which is directed toward treatment of…
FDA Approves Oral Methotrexate; Plus Restrictions for 2 Analgesics in Children
The FDA has approved a new formulation of methotrexate designed as an oral solution for pediatric patients. The agency has also recently introduced age restrictions for codeine and tramadol for children under age 12, citing their risks for slowed or difficult breathing and death…
Rheumatologists Respond to Prescription Opioid Analgesic Crisis
The alarming statistics on prescription opioid overdoses are well known to medical professionals, thanks to the Centers for Disease Control and Prevention (CDC)’s widely cited finding that deaths from opioid analgesics have increased fourfold since 1999.1 Half of all fatal drug overdoses now involve opioids prescribed by a doctor. Meanwhile, a lack of rigorous research…
Don’t Reach for Pills for Most Chronic Low Back Pain
(Reuters Health)—People should try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing treatment with over-the-counter or prescription drugs, according to new guidelines from the American College of Physicians (ACP). If the pain began recently, the guidelines recommend superficial heat, massage, acupuncture or spinal manipulation. If patients…
Rheumatology Coding Corner Year-End Quiz Questions
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
Juvenile Idiopathic Arthritis: Parents Discuss Challenges, Support Rheumatologists Can Offer
One parent wishes that she could have consulted a crystal ball at the beginning of her daughter’s illness to have “some kind of idea of what we were in for. There are so many stages of letting go of the idea of what your little kid is in for in life, what they are going…
Can Systemic Inflammation Influence Mood?
The Friday night press release: When a politician or any public figure needs to disclose unfavorable news, chances are they will release it sometime on a late Friday afternoon or evening, hoping that nobody is paying attention. In fact, this behavior was coined “the take out the trash day” on the television political drama, The…
Rheumatology Coding Corner Question: Knee Osteoarthritis
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…