Take the challenge. A—The commercial insurance coverage is primary in this situation. Medicare should be billed secondarily because it will not become primary until after the first 30 months of ESRD Medicare entitlement. After that, Medicare will be primary no matter the patient’s employment status. C—Unless the patient has a qualifying condition, such as ESRD,…
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Coding Corner Question: An Insurance Billing Quiz
A 55-year-old male patient diagnosed with generalized osteoarthritis and diagnosed with end stage renal failure (ESRD) 20 months previously presents to the office to see the rheumatologist. The patient has a commercial insurance plan and Medicare. Which carrier is primary for this visit? Commercial insurance carrier Medicare You do not know because it is not…
Study Says Mothers’ Cardiovascular Health Is Linked to Pregnancy Outcomes in Lupus
A recent study in The Journal of Rheumatology sheds light on the importance of preconceptional cardiovascular health in women with systemic lupus erythematosus. Although many questions remain, improved cardiovascular health measures seem to positively affect pregnancy outcomes, suggesting a potential role for preconception cardiovascular interventions.1 Women with lupus now have healthier pregnancies than in the…
The Cost of Free Pharmaceutical Services
The cards sat, untouched, in a corner of my desk. In the 1800s, it was common for American saloons to provide patrons with a free meal. Of course, the meal came with a catch: The meals were predictably salt laden and designed to encourage patrons to drink more beer. Hence was born the expression, “There…
Ankylosing Spondylitis & Uveitis: An Ophthalmologist’s Perspective
It’s often said the eyes are the window to the soul, and in the case of ankylosing spondylitis and other spondyloarthropathies, one can also say the eyes are the window to systemic disease. Although uveitis occurs in approximately 2–5% of patients with inflammatory bowel disease, 6–9% of patients with psoriatic arthritis and 25% of patients…
RheumPAC Advocates for Dept. of Defense Arthritis Research Funding
RheumPAC is the ACR’s non-partisan political action committee, which promotes the needs of rheumatology providers and patients. Advocacy efforts often focus on legislation to improve the day-to-day clinical care of rheumatology patients, such as establishing clinical exceptions to step therapy requirements and reforming the prior authorization process. In addition, the ACR and RheumPAC recognize the…
New Study Asks Why Lupus Patients Don’t Take Their Hydroxychloroquine
Hydroxychloroquine (HCQ) therapy may effectively manage systemic lupus erythematosus (SLE) in many patients, but that doesn’t mean patients will take it as often as they should. In fact, results from a recently published study found that about half of SLE patients were not adherent.1 The study was led by Lucy H. Liu, MD, MPH, a…
Do a Lack of Information & Social Support Affect Lupus Outcomes?
Patients with systemic lupus erythematosus (SLE) need better appraisal and more informational and social support, according to a new study on health-related quality of life in these patients.1 The phenomenological study, comprising qualitative interviews with patients in the Lupus Clinic at the Washington University School of Medicine, St. Louis, Mo., also found a need for…
Tips for Diagnosing Metabolic Myopathies
When evaluating patients with possible myopathic symptoms, rheumatologists must consider a rare, but important, group of inherited disorders: the metabolic myopathies. However, their diagnosis often remains a challenge. Early recognition of these primary metabolic myopathies is essential to help prevent disease morbidity and mortality from rhabdomyolysis. Here, we focus on the metabolic myopathies that present…
No Gain with Pain: Exercise & Physical Function in Patients with Rheumatic Disease
Pain can deter patients with rheumatic disease from engaging in physical activity. But the latest research shows exercise helps reduce pain, & other influences may also affect patients’ activity levels, particularly after surgery…
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