Chronic pain can be one of the biggest challenges that patients and their physicians face. Rheumatology patients are no stranger to pain, and when pain goes beyond the scope of what rheumatologists can treat, collaboration with a pain specialist is common. “I refer patients to pain management when there is no underlying inflammatory condition, usual…
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…
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…
The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg prednisone daily, 10 mg methotrexate weekly by mouth, 200…
When rheumatoid arthritis (RA) left Stefanie Gluckman fighting chronic pain and relegated to a wheelchair, she turned to Lori Rubenstein Fazzio, DPT, PT, MAppSc, YTRX, of Mosaic Physical Therapy in Los Angeles, for relief. Dr. Rubenstein Fazzio knows what it’s like to suffer from excruciating pain. After sustaining career-threatening injuries in a horseback accident in…
SAN FRANCISCO—The risk of stroke after herpes zoster (HZ) infection is elevated in the period immediately after infection in patients with autoimmune diseases, according to a study presented at the 2015 ACR/ARHP Annual Meeting.1 The findings were presented in a scientific session, called Discover 2015, that highlighted new research. In another study from the session,…
Patient portals are online programs and applications that help patients and physicians interact. Although there are many different implementations, most will have some sort of messaging component to help with communication between the doctor and the patient, as well as access to at least some elements of the chart, such as test results. “Patients should…
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…
In Phase 2 trials, the oral opioid, CR845, has proved promising in treating pain in patients with hip and knee osteoarthritis. Olokizumab is being investigated to treat RA, and in Canada, adalimumab has been approved to treat polyarticular JIA in 2–4 year-olds…
FDA Updates Belbuca, buccal-administered buprenorphine, has received U.S. Food and Drug Administration (FDA) approval for treating severe chronic pain.1 The dosage form is a dissolving film that is absorbed through the inner lining of the cheek for chronic pain management. It’s expected to be commercially available in the first quarter of 2016. Seven dosage strengths…