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Rheumatology Coding Corner Answer: Gout Visit for Established Patient

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CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established out­patient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…

Is Arthroscopic Meniscal Surgery Effective?

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A recent review examined the effectiveness of arthroscopic mensical surgery in treating meniscal injuries. Researchers determined that little evidence exists to support the use of arthroscopic meniscal surgery and more studies that directly compare it with nonoperative treatments are needed…

Chronic Reactive Arthritis Secondary to Intravesical Bacillus Calmette–Guerin in Bladder Carcinoma

Derick N. Jenkins, MD, Josna Haritha, MD, & Huzaefah Syed, MD  |  

A 50-year-old man with history of superficial bladder carcinoma presented to our rheumatology clinic for a three-year history of symmetric polyarthralgias. He had undergone multiple transurethral resection of bladder tumor procedures and bacillus Calmette–Guerin (BCG) treatments. Prior to receiving BCG, he was fully functional and employed. Days after receiving his second BCG treatment, he developed…

Total Joint Arthroplasty Outcome Measures Toolkit Helps Rheumatologists’ Post-Surgical Assessments

Dolores Langford, Lauren Lozinsky & Alison Hoens  |  

Amir Atwal* is a 76-year-old man who had a knee arthroplasty six weeks ago: He wonders how he is doing in comparison to other individuals of his age at the same stage of recovery. Will you be able to provide him with an answer? If you are looking for a one-stop shop to help you…

Rheumatoid Arthritis Patient Shares Lessons Learned from Breaking Leg in a Fall

Sarah Troxell, RN, BSN  |  

Humpty Dumpty sat on a wall Humpty Dumpty had a great fall All the king’s horses and all the king’s men Couldn’t put Humpty together again. —Mother Goose I feel like a female Humpty Dumpty. Recently I took a great fall, and now I am in the process of being put together again. I was…

Transition to ICD-10 Diagnostic Code Set Successful for Most Rheumatology Practices

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It has been 11 months since the implementation of the ICD-10 diagnostic code set on Oct. 1, 2015, a change from the previous ICD-9. Most practices can probably attest that the transition came and went without the predicted doomsday outcome: Claims were still processed, the confused alphanumeric coding was applied, and patients were not deprived…

The Patient's Choice

When Rheumatologists Are a Patient’s Second or Third Choice for Medical Opinion

Charles Radis, DO  |  

Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…

Conservative vs. Surgical: What Influences OA Treatment Choices?

Arthritis Care & Research  |  

Prior research has found that the use of surgery to treat osteoarthritis is increasing, while more conservative treatments, such as physical therapy, are underused. This disparity drove researchers to examine what influences a patient’s treatment choice. They found that a treatment’s characteristics—including a patient’s expectations for effectiveness and risk—affect decision making. Other influences: personal investment and circumstances, as well as support and advice from social networks and healthcare providers…

Tendinitis & Other Weight Training-Related Injuries

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With the increased popularity of CrossFit and other weight-training sports, a recent review examined the risk of injury associated with these activities. Using data from mostly retrospective studies, researchers determined that weight-training sports have a lower risk of injury than team sports, with bodybuilding having the lowest injury rate…

Treatment Options for Severe Refractory Gout When Pegloticase Fails

Diana M. Girnita, MD, PhD, Cody Lee, MD, & Christine Chhakchhuak, MD  |  

Pegloticase is a new alternative therapy for patients with severe, refractory gout unresponsive to other urate-lowering agents. The goal of this therapy is to reduce disease burden, tophi size and frequency of flares and to improve quality of life when other treatments have failed. Persistent lowering of plasma uric acid (PUA) to less than 6…