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…
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Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
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…
VA Musculoskeletal Education Pilot Program Helps PCPs Treat Patients
To improve access to quality of care for patients with osteoarthritis and other musculoskeletal pain, the U.S. Department of Veterans Affairs (VA) launched a continuing education program designed to strengthen the musculoskeletal knowledge and skills of primary care providers (PCPs). In the program’s initial trial in 2012, 19 physicians were trained on exams, treatments and joint injections. Two years after course completion, some participants increased the number of intraarticular corticosteroid injections at their clinics without needing to refer patients to specialists…
The ACR/ARHP Award Winners Discuss Their Contributions to Rheumatology
At the 2015 ACR/ARHP Annual Meeting in San Francisco in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the December 2015 issue, The Rheumatologist reported on the ACR’s awards. This month, we speak with the ARHP winners about…
Rheumatology Coding Corner Answer: Coding for Acute Flare of Idiopathic Gout
Take the challenge. M10.072—Acute gout has an Excludes 1 note of chronic gout (M1A.-). This means that acute gout and chronic gout cannot be coded for the same encounter, as the codes are mutually exclusive. M45.6—The patient is diagnosed with ankylosing spondylitis of the lumbar region. M81.8—Other osteoporosis without current pathological fracture. M79.622—The patient has…
Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA
Sternoclavicular joint involvement has rarely been reported in the context of active rheumatoid arthritis (RA).1 Traditionally, rheumatologists use serial radiographs of hands and feet to diagnose, monitor for progression or evaluate the response to treatment. The sternoclavicular (SC) joint is not a typical joint assessed for RA. However, the fact that it is a diarthrodial…
Rheumatology Research Foundation Scholarships Help Students Attend ACR/ARHP Annual Meeting
Seven students pursuing rheumatology-related careers will head to San Francisco in November on a Student and Resident ACR/ARHP Annual Meeting Scholarship—awards that are open to students and residents from states that are underserved by rheumatology professionals. The Rheumatology Research Foundation has awarded the students $750–1,500 toward travel expenses and registration for the ACR/ARHP Annual Meeting,…
Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
Phase 3 Trials: Secukinumab for Psoriatic Arthritis & DA-DKP for OA
In a global Phase 3 trial, subcutaneous secukinumab proved safe and effective in patients with psoriatic arthritis. Also, a version of aspartyl-alanyl diketopiperazine, a biologic for knee OA, has entered Phase 3 trials…
Case Report: Interstitial Lung Disease with Positive ANCA Test
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
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