Articles tagged with "patient care"

Rheumatology Coding Corner Question: Evaluation for Possible Systemic Lupus Erythematosus

From the College | November 9, 2017

History A 25-year-old female patient is seen in the office after her primary care physician requested a consultation for a possible diagnosis of systemic lupus erythematosus (SLE). The patient presents today with muscle pain in both legs, she rates the pain at an 8 on a scale of 10. She states she experiences throbbing, usually…

Hyperuricemia Doesn’t Always Indicate Gout in Rheumatic Disease

Veronika Sharp, MD, Alice Chuang, MD, Lily Kao, MD, RMSK, & Midori Jane Nishio, MD, RhMSUS | November 9, 2017

A 57-year-old Ghanaian woman was referred to our rheumatology practice with acute, left elbow swelling and pain. The referring oncologist suspected gout, because the patient had hyperuricemia. Six months before, the patient was diagnosed with stage IV human T-lymphotropic virus type 1 (HTLV-1)-associated adult T cell lymphoma (ATLL). Her initial oncologic manifestations included multiple thoracic,…

Rheumatic Disease Does Not Preclude Pregnancy

Ruth Jessen Hickman, MD | November 9, 2017

Preconception planning is essential to help women with autoimmune disease have optimal pregnancy outcomes. Unplanned pregnancy can also negatively impact disease course in some patients. Yet many rheumatologic patients of childbearing age do not receive adequate contraception or prepregnancy education and counseling. Rheumatologists must work collaboratively with other healthcare providers to make sure rheumatic patients…

Physical Activity, Exercise Can Benefit Patients with RA

August Floden, PT, MS | November 9, 2017

While medical advances in rheumatoid arthritis (RA) have led to improvements in disease control and quality of life for patients worldwide, the rate for stable remission remains low.1 Management of RA symptoms is traditionally accomplished through a combination of medications and nonpharmacological interventions.2 This approach can prevent the development of secondary adverse health outcomes. Two…

Systemic Sclerosis Mortality Rate May Be Underestimated

Kurt Ullman | November 6, 2017

Systemic sclerosis (SSc) is a disease characterized by immunologic abnormalities, microvascular involvement and tissue fibrosis. In previous studies, 10-year survival rates ranged from 50–84%. However, there are concerns that these studies, using prevalent cohorts, are underestimating mortality. “While the prognosis of many rheumatic diseases has improved with the availability of more effective and targeted therapies,…

Rheumatologists Find Nailfold Capillaroscopy an Increasingly Useful Diagnostic Tool

Ruth Jessen Hickman, MD | October 18, 2017

Interest in viewing the nail capillaries dates to the late 17th century. Later research by Maurice Raynaud and others in the late 19th and early 20th century first established a direct link between the nailfold capillaries and certain medical conditions. Although underutilized in the past, with the advent of modern digital equipment and the validation…

Rheumatologist’s Passion for Gardening Keeps Plants, Patients Healthy

Carol Patton | October 18, 2017

Deborah Dyett Desir, MD, vividly remembers her first day as an undergraduate student at Harvard University, Boston. When her parents helped her move into the dorm, her mother, Betty, handed her a beautiful begonia. “My response was, ‘What on earth am I going to do with this plant?’” she says, recalling how she examined the…

Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2

From the College | October 18, 2017

Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…

Rheumatology Coding Corner Question: Prolonged Service without Direct Patient Contact, Part 2

From the College | October 18, 2017

An established, 66-year-old male patient is seen in the office for a follow-up visit for his fibromyalgia. The physician makes the decision to prescribe venlafaxine for anxiety and depression, and gabapentin for nerve pain. After the visit, the physician informs his medical assistant (MA) to contact the patient’s insurance carrier because venlafaxine requires a prior…

The ARHP Helps Rheumatology Professionals Avoid Information Overload

Erin Latimer Meadows | October 18, 2017

In a world where some information is good, more information is better and information overload is a way of life, Carole Dodge, BS, OTR, CHT—a practicing occupational therapist at the University of Michigan—considers the ARHP her professional block and tackle. “ARHP helps me sift through a lot of information and get it to a digestible…