Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…
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Rheumatologist Channels Military Aspirations into Role with U.S. Navy Reserve
In 2010, Thomas Bartow, MD, FACP, finally ran out of excuses. Ever since high school, he had wanted to join the military. But too many things got in the way—like attending medical school at State University of New York at Stony Brook. After graduation in 1980, he performed his residency in internal medicine at Rush-Presbyterian-St….
Does MRI Differentiate Osteoarthritis and Meniscal Tear in Knee Pain?
When a young patient arrives at a clinic complaining of knee pain with clicking or popping, a meniscal tear is often the culprit. “In young [people], there’s a pretty classic presentation of meniscal tear, with clicking and other mechanical symptoms, because the tear rubs up against different tissues,” says Jeffrey Katz, MD, MSc, a rheumatologist…
Long-Term Benefits, Risks of Biologic Disease-Modifying Anti-Rheumatic Drugs in Patients with RA
Two decades have passed since the first biologic disease-modifying anti-rheumatic drug (bDMARD) was approved. Studies on the long-term use of biologics in different disease states, such as for cardiovascular disease (CVD) and malignancy, as well as for knee/hip replacement, reveal some encouraging news. In clinical trials, bDMARDs have been shown to increase the risk of…
Rheumatology Drug Updates: Hip Fracture Rates After Bisphosphonate Drug Holidays, Plus More on Golimumab, Ustekinumab
Bisphosphonate Drug Holidays Drug holidays are common for patients on bisphosphonate therapy. Often, these breaks in treatment are related to known U.S. Food and Drug Administration (FDA) warnings and drug class adverse effects. Currently, data on fracture risk related to drug holidays are limited. In recent research highlighted at the 2017 ACR/ARHP Annual Meeting ,…
Fellows’ Forum Case Report: Progressive Weakness and Debilitation with Skin Rash
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
Inside Cambodia’s Struggles with Poverty, Dearth of Trained Rheumatologists
It’s one thing for a developing country to lack physicians due to a scarcity of training. It’s quite another for such a vacuum to exist because the physicians were executed. In Cambodia in the 1970s, genocide perpetrated by the Khmer Rouge spared few of the educated class. If they were spared, chances were they lost…
Cardiovascular Disease Rate Differs Between SLE Patients of Different Races, Ethnicities
A recent epidemiologic study of patients with systemic lupus erythematosus (SLE) investigated racial and ethnic differences in the risk for cardiovascular disease (CVD). Among SLE patients enrolled in Medicaid, the risk for myocardial infarction (MI) was lower in Hispanics and Asians compared with whites, and the risk of stroke was higher in blacks and Hispanics…
Is Rheumatoid Arthritis Preventable?
Is rheumatoid arthritis (RA) preventable? Results of a newly published study suggest that personalized medicine approaches may result in health behavior that may reduce RA risk. “We have gotten to the point where we’ve identified some modifiable behaviors that affect rheumatoid arthritis risk,” says Jeffrey A. Sparks, MD, MMSc, assistant professor of medicine in the…
Strong Statistical Association Found Between Trauma and Lupus
They say the body remembers what the mind wants to forget. For those who have experienced trauma, not only does the body remember, in some cases it works on making things worse. Such is the situation with trauma and lupus, says a new study published in Arthritis & Rheumatology in October. The study, titled, “Association…
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