Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…
Search results for: osteoporosis
Rheumatology Coding Corner Answer: Coding for Acute Flare of Idiopathic Gout
Take the challenge. M10.072—Acute gout has an Excludes 1 note of chronic gout (M1A.-). This means that acute gout and chronic gout cannot be coded for the same encounter, as the codes are mutually exclusive. M45.6—The patient is diagnosed with ankylosing spondylitis of the lumbar region. M81.8—Other osteoporosis without current pathological fracture. M79.622—The patient has…
Rheumatology Coding Corner Question: Coding for Acute Flare of Idiopathic Gout
It has been two months since the implementation of ICD-10, so everyone has gotten a feel for the new code set. Let’s see how well you are doing in your diagnosis coding for rheumatology-specific conditions. A 55-year-old female patient presents for a follow-up visit of idiopathic chronic gout of multiple joints without tophi. She complains…

Understanding the Z Codes in ICD-10
Two months into the transition, the ICD-10 code set is still not exactly the most enticing reading material. But there is still so much to learn and apply, that it is necessary for physicians, coders and billers to stay abreast of the coding and billing guidelines. Although all of the guidelines and conventions may be…

Rheumatologists on the Move, November 2015
Nancy Baker, ScD, Completes Sabbatical Year at CDC Nancy Baker, ScD, MPH, OTR/L, associate professor in the Department of Occupational Therapy at the University of Pittsburgh, recently completed a yearlong sabbatical as a researcher at the Centers for Disease Control & Prevention (CDC), Division of Population Health. Her mentor at the CDC, Kristina Theis, MPH,…

When Sense Disorders Signal Immune System Interactions
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…

Improve RA Care with Vitamin D
Background Autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematous, occur when the body attacks its own tissue because it cannot differentiate between self and non-self. This is mainly through deregulation of the immune system. Vitamin D has been known to play a critical role in bone mineralization and bone health. Activated vitamin…

Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
Bone Turnover Markers Show Link to Iliac Histomorphometry in Older Women
NEW YORK (Reuters Health)—Although histomorphometry of iliac bone gives precise results, bone turnover markers provide a better reflection of the overall skeleton in untreated postmenopausal osteoporotic women, according to French researchers. Bone histomorphometry allows study of bone remodeling at the basic structural unit level, Dr. Pascale Chavassieux and colleagues at the University of Lyon note…

Researchers Identify Molecule That Promotes Osteogenesis
New insights into bone cell biology—including the identification of parbendazole, a bone anabolic compound that promotes bone formation—may lead to better treatments for osteoporosis…
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