Take the challenge. CPT codes: 99214-25, 20610-RT, J1030x1 Diagnoses: M05.79, M25.561 This is an established patient visit with an established diagnosis, along with a new diagnosis, which would have to be billed under the PA’s National Provider Number (NPI) and reimbursed at 85% of the fee schedule. Keep in mind that to qualify as an…
What Do Diabetes, Islet Cells & Autoimmunity Have in Common?
“Man may be the captain of his fate, but he is also the victim of his blood sugar.” —Wilfrid Oakley, MB BChir, an early pioneer in diabetes care Perusing the list of the most notable medical achievements in the 20th century, a reader may conclude that the discovery of insulin should rank in a category…
HSCT for Severe Autoimmune Diseases
Despite the innovations of new biologics and disease-modifying anti-rheumatic drugs, a large unmet need remains for patients with rheumatic autoimmune disease. Treatment remains limited for many conditions, including for conditions with a dim prognosis, such as systemic sclerosis.1 One promising treatment avenue is hematopoietic stem-cell transplantation (HSCT). Here, we provide background on HSCT for severe…
Fellows’ Forum Case Report: Hemophagocytic Lymphohistiocytosis
The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
Gut Microbe, Prevotella copri, Implicated in RA Pathogenesis
New research reinforces the hypothesis that the gut microbiome triggers mucosal and systemic immune responses in patients with rheumatoid arthritis. The research, published in Arthritis & Rheumatology May 2017, found that subgroups of patients with RA have differential immunoglobulin G (IgG) or IgA immune reactivity with Prevotella copri, an intestinal microbe that appears to be…
The ARHP Promotes Interdisciplinary Approach to Rheumatology Patient Care
Editor’s note: The new Pillar Talk column is developed by the ARHP Executive Committee in an effort to share information about ongoing activities related to our four pillars: Education, Practice, Research and Advocacy. The ARHP Practice Committee is committed to addressing the current needs and evolving practice opportunities for health professionals working in rheumatology. A…
Rheumatology Coding Corner Question: Coding for Incident-to Services
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
RISE Registry Data Now Available for Research Purposes
As medical professionals, we understand the impact quality research can have on how we care for our patients. The extensive adoption of electronic health records (EHRs) has enabled the collection of big data in rheumatology. This has provided a new and unique opportunity for the rheumatology community to conduct in-depth research into how patients are…
Rheumatology Coding Corner Question: Established Patient Office Visit with Acute Gout
A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…
Rheumatology Coding Corner Answer: Established Patient Office Visit with Acute Gout
Take the challenge. CPT: 99214-25, 89060, 20600-RT ICD-10: M10.271, T50.2X5A, I10 This is an established outpatient visit. This encounter is coded as 99213, because it included: History—Detailed: The history of present illness is extended, the review of systems is extended, and the past medical and social histories are documented. Examination—Detailed: Seven organ systems are examined….
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