Take the challenge. CPT: 99203 This encounter is coded as 99203, because it included: History—The history of present illness was extended. The review of systems was complete, and the past medical, family and social were documented. This makes the history comprehensive. Examination—Expanded detailed. Medical decision making—The diagnosis was a new problem with no additional workup…
Search results for: pain
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
Draft Criteria for ANCA-Associated Vasculitis Released
WASHINGTON, D.C.—Rheumatologists do not have up-to-date diagnostic and classification criteria for vasculitis, a group of diseases that involves inflammation of the blood vessels, said experts speaking at the 2016 ACR/ARHP Annual Meeting session, Classification Criteria for ANCA-Associated Vasculitis. The most recent classification criteria were published by the ACR in 1990, and since then, new disease…
Quality Measures Used to Assess Care, Improve Outcomes in Children, Adults with Rheumatic Diseases
WASHINGTON, D.C.—In a session during the 2016 ACR/ARHP Annual Meeting, aptly called Quality Measures and Quality of Care I, a panel of experts presented information on a number of programs underway in rheumatology using quality measures to both assess and improve patient outcomes. Leading off were two presentations on programs using quality measures to improve…
Research Offers Insight into Diagnosis, Treatment of Small-Vessel Vasculitis
WASHINGTON, D.C.—Experts speaking at the 2016 ACR/ARHP Annual Meeting session, Update on Small-Vessel Vasculitis, offered insight into the latest approaches to the diagnosis and treatment of diseases involving the inflammation of blood vessels. “Vasculitis is an immune-mediated process. White blood cells invade the vessel wall, causing inflammation throughout the vessel wall,” said Jason M. Springer,…
fMRI Can Help Diagnose Fibromyalgia
Brain imaging can distinguish fibromyalgia patients from healthy controls with high sensitivity and specificity, according to two papers published nearly simultaneously in Pain late last summer, by groups at the Universities of Colorado and Michigan, respectively. Somewhat surprisingly to the authors and others, in the Colorado study, which used both painful and nonpainful stimuli, the…
Environmental Factors in Pediatric Systemic Autoimmune Diseases
Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…
On the Road in Rajasthan: Vehicular-Caused Bone, Joint Damage in India
In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…
How to Diagnose Antisynthetase Syndrome
Antisynthetase syndrome (AS) is strongly associated with the presence of antibodies to aminoacyl-transfer RNA (tRNA) synthetases (ARSs) that are implicated in the pathogenesis of myositis and interstitial lung disease (ILD). Antibodies against eight antisynthetases have been identified and are detected in 16–26% of patients with idiopathic inflammatory myopathies (IIM).1 Serum assays for five of these…
What Our Colleagues Should Know: Neurologists & Rheumatologists Must Communicate
Neurologists and rheumatologists focus on atypical diseases, and their treatments often require insights from both specialties. Philip Seo, MD, MHS, says communication between specialists is key to diagnosis and treatment…
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