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Rheumatology Coding Corner Answer: Coding & Billing Basics

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Take the challenge. 1. D: All of the above Rationale: Per CPT, if time spent counseling and/or coordinating care dominates the session, then total time must be documented; greater than 50% of the time must be for face-to-face counseling and/or coordinating care, and must be documented as such. Additionally, the extent of the counseling and/or…

Diagnostic Imaging in Patient with Chronic Left Ankle Pain: Findings

Cianna Leatherwood, MD, & Derrick J. Todd, MD, PhD  |  

Radiographic imaging showed circumferential soft tissue swelling of the ankle with a soft-tissue density seen in the tibiotalar and posterior subtalar joints, as well as a large, lobulated effusion. MRI of the left ankle shows cystic changes within the talus and first cuneiform bones, as well as a lobulated abnormal soft tissue density with low…

2015 ACR/ARHP Annual Meeting: Macrophage Polarization and Its Role in Inflammatory Disease

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SAN FRANCISCO—To unravel how out-of-control inflammation begins in rheumatoid arthritis and other diseases, one target for immunologists is the macrophage. Researchers discussed macrophage activation and other key drivers of inflammation at the 2015 ACR/ARHP Annual Meeting on Nov. 7. How macrophages behave when recognizing damage-associated molecular pathways (DAMPs) tells us more about why some inflammation doesn’t…

2015 ACR/ARHP Annual Meeting: Novel Approaches for Intra-Articular Arthritis Therapy

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SAN FRANCISCO—Penetrating the dense extracellular matrix of cartilage is a challenge for administering osteoarthritis drugs, but an answer might lie in the matrix itself—in particular, its electrical charge, researchers reported at the 2015 ACR/ARHP Annual Meeting. Electrical Affinity Investigators at the Massachusetts Institute of Technology have found—at least in vitro and in animals—that delivering drugs…

2015 ACR/ARHP Annual Meeting: Better Pain Prevention, Treatment Needed for Older Adults

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SAN FRANCISCO—A broadening of the medical community’s horizons in how pain is regarded and treated in older adults, including those with osteoarthritis and other rheumatic diseases, is sorely needed, a researcher said at the 2015 ACR/ARHP Annual Meeting. Incidence Studies show that a large percentage of older adults each year see physicians for such issues…

Ethics Forum: Pediatric Vaccination Refusals Raise Challenges for Physicians

Emily von Scheven, MD, MAS  |  

The boy who could not walk: S.L. is a previously healthy 10-year-old boy who has not walked for three months. Physical examination reveals swollen wrists, knees, ankles and several toes. There is reduced hip range of motion and flexion contractures of both knees. He can stand with assistance, but is unable to take a single…

Rheumatology Drug Updates: Opioid CR845 for OA Pain; RA Treatments in Development

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CR845—an oral, peripherally selective kappa opioid agonist—is currently in Phase 2 trials for the treatment of pruritus, and acute and chronic pain.1 Eighty patients with hip osteoarthritis (OA) or knee OA were randomized to receive treatment with 0.25 mg, 0.5 mg, 1.0 mg or 5.0 mg CR845 twice daily for two weeks. Safety assessment, pharmacokinetics…

2015 ACR/ARHP Annual Meeting: Genetic Links Emerge in Osteoarthritis

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SAN FRANCISCO—As researchers have delved into the genetics behind osteoarthritis (OA), genes that appear to be players in the disease have emerged, but there have also been curveballs thrown, with expectations not always matching up to the genetic realities, an expert said at the 2015 ACR/ARHP Annual Meeting. The genetic risk of acquiring OA is…