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….
Biochemical Insights into Progeria Syndrome Identify Bisphosphonates, Statins as Possible Candidate Drugs to Halt Aging
Can We Stay Forever Young? May your heart always be joyful And may your song always be sung May you stay forever young Forever Young —Bob Dylan Beneath the rubric of orphan diseases reside some rare conditions and others that are extraordinarily uncommon. These are the diseases that most physicians either never to get to…
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…
Rheumatology Coding Corner Answer: Physical Examination with Infliximab Infusion
Take the challenge. CPT: 99214-25, 96413, 96415 x 1, J1745 x 35 ICD-10: M07.68, K51.80 Billing Overview It is appropriate to bill for an E/M visit for this day of service along with the infusion procedure. Modifier 25 should be appended to the E/M, indicating that the patient received a significant, separately identifiable E/M service…
Rheumatology Coding Corner Question: Physical Examination with Infliximab Infusion
A 12-year-old male established patient with inflammatory bowel disease with associated juvenile spondyloarthropathy returns to the office for a follow-up visit for his infliximab infusion. The patient reports moderate pain in his right hip after walking for extended periods of time or after sports activities. He denies any other joint pain and denies any joint…
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…
Rheumatology Drug Updates: Labeling for Fluoroquinolones; FDA to Review Benzhydrocodone/Acetaminophen Combination
FDA Restricts Fluoroquinolone Use The U.S. Food and Drug Administration (FDA) has twice previously communicated safety information about systemic fluoroquinolones—in August 2013 and July 2008. The safety issues of this medication class described in its latest Drug Safety Communication were also discussed at a November 2015 FDA Advisory Committee meeting.1 The FDA is now advising…
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…
Medical Marijuana’s Potential Benefits, Risks
CHICAGO—Despite the complicated politics surrounding medical marijuana, cannabis has a wide variety of medical benefits and potential benefits, but the risks need to be understood, said Daniel Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, in a session at the ACR’s 2016 State-of-the-Art Clinical Symposium. Effects It’s…
Lupus Expert Calls for Better Research, Outcomes of Clinical Trials
CHICAGO—A lupus expert recently issued a call for action to improve outcomes of lupus clinical trials, a field that has had so many failed potential therapies that he said it seems to be “cursed.” Richard Furie, MD, chief of rheumatology at Northwell Health in New York, said at the ACR’s 2016 State-of-the-Art Clinical Symposium that…
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