Take the challenge. B—No. Although the documentation states the patient arrived at the clinic at 8:15 a.m. and left the clinic at 10:55 a.m., it does not document the actual start and stop times of the infusion. According to CPT, when reporting codes for which infusion time is a factor, use the actual time over…
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Rheumatology Drug Updates: Infliximab Biosimilar Gets FDA Approval & More
April 5, 2016, marks a revolutionary day in the treatment of autoimmune diseases: The U.S. Food and Drug Administration (FDA) approved an infliximab (Remicade) biosimilar, known as Inflectra (infliximab-dyyb). Infliximab-dyyb, which is administered by intravenous infusion, is the first biosimilar drug approved to treat rheumatic disease in the U.S.1 Infliximab-dyyb has received approval for almost…

Study Associates Higher Risks with Total Joint Arthroplasty among Patients with Hepatitis C
A study that looked at the impact of hepatitis C on short-term outcomes of total joint arthroplasty found an increase in co-morbidity compared with patients without the liver disease. The number of people in need of total joint arthroplasty is expected to rise in conjunction with an aging population and advances in hepatitis C treatments….

Tips for Increasing Your Client Base
Recruiting new patients requires a multi-faceted approach. A rheumatologist must have a solid brand and marketing platform, as well as an active strategy to attract and convert new patients. This might involve embracing social media, having a website, developing a referral network, being involved in your community and nurturing existing patients. Your brand includes such…
Rheumatology Coding Corner Question: Coding & Billing Basics
When reporting E/M service levels, if time spent counseling and/or coordinating care dominates the session, which of the following is true? Total time must be documented Greater than 50% of the time must be for face-to-face counseling and/or coordinating care The extent of the counseling and/or coordinating care must be documented All of the above…
Rheumatology Coding Corner Answer: Coding & Billing Basics
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
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
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: Cellular Triggers in Inflammatory Disease
SAN FRANCISCO—What factors help determine whether or not inflammation resolves, leading to healing, or becomes chronic, leading to disease and tissue destruction? A number of important cells, including toll-like receptors, mast cells, anti-citrullinated protein antibodies, complement and interferon, all play their own role in this process. By understanding how they act in innate and adaptive…

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