Take the challenge. Correct Coding: 99213-25, 20552 Diagnosis: M79.70 There continues to be a lot of confusion on proper coding for trigger-point injections. Two CPT4 codes can be used: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Injection(s); single or multiple trigger point(s), three or more muscle(s). The CPT4 codes are based…

Opinion: Rheumatologists Cautioned Against Wasteful Testing to Find Rare Diseases
What rheumatologist doesn’t love the good old zebra hunt? You know—the pursuit of diagnosing the extraordinarily rare disease purely through pluck and wits. The zebra hunt is almost a tradition, a perennial topic of polite, but subtly boastful, conversation among peers and the subject of numerous career-building case reports. The hunt also happens to be…

Opinion: Why Rheumatologists Should Adhere to Standard of Care
It is valuable to understand the semantics of consultant comments. A journal article I once read indicated that when a consultant reports having seen a series of individuals with a given problem, it means they have seen two cases. When they report they have experience with a problem, they mean they have seen a (one)…

How to Avoid Legal Pitfalls
In busy rheumatology practices, mountains of paperwork for insurance companies and federal healthcare programs make it hard to keep track of what’s legal. Missing documentation is the most common way to spark an investigation. Here are a few considerations to help you avoid legal pitfalls…

The Future of Rural Rheumatology: A Discussion with Dr. Robert Jackson
Rheumatologists practicing in rural and urban areas face different challenges. Robert Jackson, DO, discusses how technology, healthcare reform and hospital closures affect rheumatology practice in rural areas and its future…

5 Considerations to Help Jumpstart Your New Rheumatology Practice
Starting your own rheumatology practice is daunting, and it’s easy to focus on the medical side and neglect the business side of a practice. Here are five important considerations that could help a new practice thrive…
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…

New President Dr. Von Feldt Looks at Where ACR Is Headed in 2016
I am honored, humbled and excited to serve as your ACR president. I’d like to share the following background information to illustrate the diverse set of life experiences I draw from to represent the ACR membership effectively. Personal Background Thanks to my mom, who was born and raised in Guatemala, I am bilingual in Spanish…
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…

Looking Back on Rheumatology in 2015, Leaping Forward to the Year Ahead
My dear friends, we come to praise Caesar. As we march toward 2016, we ought to acknowledge the great Roman emperor’s role in creating a proper calendar. At the start of Caesar’s reign, the calendar year lasted 355 days, 10¼ days fewer than the time it took the earth to fully orbit the sun.1 Although…
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