Level 3 Established Patient E&M Visit A 43-year-old patient is seen in the office for a follow-up visit of her RF-positive rheumatoid arthritis and primary osteoarthritis of the left knee. The patient is on sulindac, methotrexate and folic acid. At her last visit, the patient’s methotrexate dose was increased, which has greatly reduced her pain….
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Rheumatology Informatics System for Effectiveness (RISE) Registry Can Help Rheumatologists Meet MACRA Requirements
The ACR has been at the forefront of helping rheumatologists meet practice demands, including federal reporting requirements. The first registry that helped meet these requirements was the Rheumatology Clinical Registry (RCR), and it facilitated quality reporting, but required manual entry of required data. More recently, ACR has contracted with FIGmd to create a tool that…
How Sick Is Your Patient? Document the Details!
Clear. Complete. Concise. These three Cs describe ideal patient record keeping, which is why they are among the key reasons to implement a clinical documentation information (CDI) program into your rheumatology practice. Not only will CDI help you accurately document the full picture of each patient’s clinical status, but it also promotes high-quality care and…
Proposed CMS Physician Fee Schedule May Offer Slight Increases
All eyes are on the new physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS), which will be finalized this year and go into effect Jan. 1. The ACR is reviewing the proposal and will be providing comments and recommendations to CMS. And many rheumatologists have payment and coding questions: Will…

Ultrasound May Be Useful for Grading Rotator Cuff Tendinopathy
Researchers have developed procedures and assessed their efficacy for the use of ultrasound images to measure the inter-rater reliability of the measurement of structural changes in the tendon of patients with supraspinatus tendinopathy. The standardized procedures proved useful in evaluating patients…

New FDA Warnings: Patients on SGLT2 Inhibitors at Risk of Acute Kidney Injury & Loperamide Abuse on the Rise
The FDA is strengthening its warning that canagliflozin and dapagliflozin may increase the risk for acute kidney injury in some patients. Also, the FDA has issued a warning that patients should not exceed recommended doses of loperamide due to increased risks of serious cardiac events…

Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…

Exercise Therapy Recommended to Manage Knee Osteoarthritis
The benefits of exercise therapy for individuals with knee osteoarthritis (OA) are well known. The ACR strongly recommends both aquatic exercise and land-based aerobic and resistance exercise for managing knee OA.1 A recent Cochrane systematic review and meta-analysis concluded that high-quality evidence supports the use of exercise to reduce pain and improve physical function and…

Practicing Telemedicine Raises Legal Considerations for Rheumatologists
With the evolution and advancement of technology, it was only a matter of time before such changes affected the medical industry. Although the concept of telemedicine dates back more than 50 years, emphasis on cost-effective quality healthcare coupled with technological advancements has caused a resurgence of telemedicine in recent years. What constitutes telemedicine largely depends…

Why Rheumatologists Should Focus on Patients’ Cardiovascular Health
Baseball is a great sport. It’s fascinating to watch the evolving duel between pitcher and batter. As the former employs their remarkably powerful and versatile rotator cuff and forearm flexor muscles to hurl blazing pitches, the latter engages their exceptionally honed hand–eye neural link to make contact with the ball. Baseball is the ultimate summertime…
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