“Juvenile Arthritis Month” is observed in the month of July in the United States. Sponsored by the Arthritis Foundation, the campaign is a unique platform to generate widespread awareness about juvenile arthritis (JA) – an auto-immune disease – and donate towards much needed research in this area. Reports show that an estimated 300,000 children in the United States – that is 1 in 250 kids (2020 statistics) – are affected by some form of JA. Formerly known as juvenile rheumatoid arthritis, this is the most common type of arthritis in children under the age of 16.

The condition is characterized by inflammation of the tissue that lines the inside of the joints (also known as the synovium). It can cause persistent joint pain, swelling and stiffness. In certain cases, children may experience symptoms for only a few months, while others have symptoms for many years. However, in rare cases, the condition can last a lifetime. Identifying the symptoms of JA is important for getting treatment before the condition progresses. Treatments for this condition are based on the type of juvenile arthritis and may generally include – medications and different exercise patterns to reduce the symptoms.

Pediatric rheumatologists providing treatment for this condition need to ensure that the medical billing and coding for the condition is properly done on their medical claims. To ensure correct clinical documentation and reimbursement, physicians can rely on the services of reputable medical billing outsourcing companies.

The 2021 month-long observance aims to increase awareness and promote the need for a cure for juvenile arthritis, and spur advocacy on behalf of those suffering from this health condition. The disease may take a physical and emotional toll on kids, often resulting in debilitating pain and feelings of loneliness or depression. Juvenile Arthritis month observance aims to empower kids, teens, young adults and their families through support, education and forging connections.

Some of the common types of Juvenile arthritis are – Systemic arthritis (also called Still’s disease), Oligoarthritis (pauciarticular juvenile rheumatoid arthritis), Polyarthritis (polyarticular juvenile idiopathic arthritis), Psoriatic arthritis, Enthesitis-related arthritis and undifferentiated arthritis (which does not fit within any other subtypes). Each specific type of arthritis may affect each child differently and the symptoms can last for indefinite periods of time. It is estimated that certain forms of JA are more common among girls.

Through this month-long campaign, the Arthritis Foundation aims to generate funds for arthritis research to find a cure for the hundreds of thousands of children suffering from this debilitating, auto-immune disease. By supporting arthritis research specific to juvenile arthritis every year, the campaign hopes to provide a better life for the kids and their families living every day with arthritis.

The exact cause of juvenile arthritis in not known. However, researchers believe that the condition primarily being an autoimmune disease – in which the immune system mistakenly attacks its own cells and tissues. Several factors like heredity and environment seem to play an active role. Generally, juvenile arthritis may affect one joint or multiple joints. Signs and symptoms associated with the condition may differ from one child to another and the type of arthritis a child suffers from.

The more the number of joints affected, the more severe the disease. At times, the symptoms may improve, disappear (remissions) or worsen (flare-ups). On the other hand, a child may experience one or two flare-ups and never have symptoms again. In certain other cases, children may have frequent flare-ups and symptoms that never go away.

Some of the most common symptoms include – pain, swelling, and tenderness in the joints, joint stiffness (especially in the morning), persistent fever, eye redness or pain, irritability, fatigue, weight loss, blurred vision, limping (in younger children), reduced range of motion and swollen lymph nodes.

Diagnosis of juvenile arthritis can be challenging as the main symptom, namely joint pain, can be caused by many different types of problems.

There is no single test that can clearly confirm a diagnosis, but a combination of certain tests can help rule out other conditions that produce similar signs and symptoms. A combination of blood tests like – Erythrocyte sedimentation rate (ESR), C-reactive protein, Rheumatoid factor, Anti-nuclear antibody, Cyclic citrullinated peptide (CCP) may be performed to confirm the diagnosis. Imaging scans like – X-rays or Magnetic resonance imaging (MRI) may be performed to exclude other conditions such as fractures, tumors, infection or congenital defects. Imaging may also be used from time to time after the diagnosis to monitor bone development and detect joint damage. In addition, bone scans, joint fluid sampling and synovial tissue sampling will also be done to rule out other conditions that generate similar signs and symptoms. Treatment modalities for juvenile idiopathic arthritis focus on helping the child maintain a normal level of physical and social activity. As part of this, physicians may use a combination of strategies to relieve pain and swelling, maintain full movement and strength, and prevent complications. Medications like non-steroidal anti-inflammatory drugs (NSAIDs), slow-acting anti-rheumatic drugs (SAARDs), Corticosteroids and anti-metabolites may be prescribed to help children with JA manage pain, improve function and minimize potential joint damage.

Physical therapy exercises may also be recommended to help keep the joints flexible and maintain range of motion and muscle tone. In very severe cases, surgery may be needed to improve joint function. Incorporating self-care techniques like – getting regular exercise, applying cold or heat packs, and eating a well-balanced diet can help limit the effects or complications of juvenile idiopathic arthritis to a great extent.

Pediatric rheumatologists or other rheumatology specialists treating JA patients must carefully document the symptoms, diagnosis, and treatment administered using the correct medical codes. Billing and coding services provided by experienced medical billing companies can help physicians use the correct codes for their billing purposes.

ICD-10 diagnosis codes for Juvenile arthritis (JA) include –

  • M08 Juvenile arthritis
  • M08.0 Unspecified juvenile rheumatoid arthritis
    • M08.00 Unspecified juvenile rheumatoid arthritis, of unspecified site
    • M08.01 Unspecified juvenile rheumatoid arthritis, shoulder
      • M08.011 Unspecified juvenile rheumatoid arthritis, right shoulder
      • M08.012 Unspecified juvenile rheumatoid arthritis, left shoulder
      • M08.019 Unspecified juvenile rheumatoid arthritis, unspecified shoulder
    • M08.02 Unspecified juvenile rheumatoid arthritis of elbow
      • M08.021 Unspecified juvenile rheumatoid arthritis, right elbow
      • M08.022 Unspecified juvenile rheumatoid arthritis, left elbow
      • M08.029 Unspecified juvenile rheumatoid arthritis, unspecified elbow
    • M08.03 Unspecified juvenile rheumatoid arthritis, wrist
      • M08.031 Unspecified juvenile rheumatoid arthritis, right wrist
      • M08.032 Unspecified juvenile rheumatoid arthritis, left wrist
      • M08.039 Unspecified juvenile rheumatoid arthritis, unspecified wrist
    • M08.04 Unspecified juvenile rheumatoid arthritis, hand
      • M08.041 Unspecified juvenile rheumatoid arthritis, right hand
      • M08.042 Unspecified juvenile rheumatoid arthritis, left hand
      • M08.049 Unspecified juvenile rheumatoid arthritis, unspecified hand
    • M08.05 Unspecified juvenile rheumatoid arthritis, hip
      • M08.051 Unspecified juvenile rheumatoid arthritis, right hip
      • M08.052 Unspecified juvenile rheumatoid arthritis, left hip
      • M08.059 Unspecified juvenile rheumatoid arthritis, unspecified hip
    • M08.06 Unspecified juvenile rheumatoid arthritis, knee
      • M08.061 Unspecified juvenile rheumatoid arthritis, right knee
      • M08.062 Unspecified juvenile rheumatoid arthritis, left knee
      • M08.069 Unspecified juvenile rheumatoid arthritis, unspecified knee
    • M08.07 Unspecified juvenile rheumatoid arthritis, ankle and foot
      • M08.071 Unspecified juvenile rheumatoid arthritis, right ankle and foot
      • M08.072 Unspecified juvenile rheumatoid arthritis, left ankle and foot
      • M08.079 Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot
    • M08.08 Unspecified juvenile rheumatoid arthritis, vertebrae
    • M08.09 Unspecified juvenile rheumatoid arthritis, multiple site

As part of the campaign, healthcare organizations across the country conduct a wide range of programs that would help provide adequate resources to those families that are fighting juvenile arthritis.

Creating awareness is key to making Juvenile Arthritis Awareness Month a success. People can participate in this campaign by sharing their story of struggle with JA online via social media platforms like Facebook and Twitter as this can help convey the need for and importance of arthritis research.

They can share their Cure Arthritis pictures on social media using hashtags #CureArthritis and #KidsGetArthritis – to show their support and raise awareness about JA. Blue is the official color of the campaign and people can lend their support to the campaign by wearing wristbands, ribbon magnets and lapel pins throughout this month.