Rheumatic and musculoskeletal diseases, often referred to as RMDs, are universally prevalent chronic non-communicable diseases. Arthritis, a significant component of RMDs, is an inflammatory joint disorder, which affects tissues around the joint and other connective tissues, causing joint pain and stiffness. Medical billing and coding services play a crucial role in managing healthcare processes related to arthritis and other RMDs.
Initially established by Arthritis and Rheumatism International (ARI) in 1996, World Arthritis Day is celebrated each year on October 12. This global observance focuses on raising awareness about arthritis, educating the public about it, highlighting the importance of early diagnosis and treatment, and campaigning for better support and treatment options.
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What is Arthritis?
The word “arthritis” is derived from the Greek words ‘arthro,’ meaning ‘joint,’ and ‘itis,’ meaning ‘inflammation.’ So, arthritis literally means “joint inflammation”. There are more than 100 different forms of arthritis and related diseases with different causes and treatments. The most prevalent types are osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), gout, fibromyalgia, and juvenile arthritis. Arthritis can affect organs such as the lungs, heart, and eyes.
It is estimated that more than 350 million people have arthritis globally (Global RA Network, 2021). According to the World Health Organization, about 528 million people worldwide were living with osteoarthritis in 2019, an increase of 113% since 1990. Furthermore, about 73% of people living with osteoarthritis are older than 55 years, and 60% are female. With aging populations and increasing rates of obesity and injury, the prevalence of arthritis is expected to continue to increase globally.
The Centers for Disease Control and Prevention estimated that 1 in 4 adults have arthritis (2020 statistics). From 2016 to 2018, 27.2% women and 20.0% of men reported doctor-diagnosed arthritis in the United States (NHIS). It is estimated that by 2040, 78 million U.S. adults will have arthritis (Arthritis & Rheumatology, 2016). Osteoarthritis is the most common joint disorder in the United States.
Types of Arthritis
Arthritis is a complex disorder that can be caused by various conditions such as autoimmune diseases, injuries, infections, normal wear and tear on joints, and genetics. Common symptoms of arthritis include pain, redness, heat, and swelling in the joints.
There’s no cure for arthritis. Treatment is aimed at controlling symptoms and preventing joint damage. Without treatment, arthritis can be disabling.
Here is an overview of 4 common types of arthritis along with their diagnosis codes:
- Osteoarthritis (OA): OA is the most common type of arthritis. It is a degenerative joint disease, in which the tissues in the joint break down as you age. The most commonly affected joints are the hands, knees, hips, and spine. OA can damage all the areas of the joint, including the cartilage and lining, tendons and ligaments, bone, and the meniscus in the knee. Osteoarthritis causes joint pain after rest or inactivity, swelling, and loss of joint motion. The ICD-10 codes for osteoarthritis fall in the range: M15-M19.
- M15 Polyosteoarthritis
- M16 Osteoarthritis
- M17 Osteoarthritis of knees
- M18 Osteoarthritis of first carpometacarpal joint
- M19 Other and unspecified osteoarthritis
- Rheumatoid Arthritis (RA): Rheumatoid arthritis is an autoimmune and inflammatory disease. In RA, the body’s immune system mistakenly attacks its own healthy cells in the body, causing painful swelling in the affected area. The specific causes of RA are unknown, but factors such as age, sex (being a woman, genetics, and smoking can increase the risk of developing the disease.
RA typically affects joints in the hands, wrists, and knees, and more than one joint at once. The lining of the affected joint becomes inflamed, causing damage to joint tissue, causing chronic pain, unsteadiness, and deformity. The ICD-10 codes for RA fall in the range M05-M06
- M05 Rheumatoid arthritis with rheumatoid factor
- M06 Other rheumatoid arthritis
- M06.0 Rheumatoid arthritis without rheumatoid factor
- M06.1 Adult-onset Still’s disease
- M06.2 Rheumatoid bursitis
- M06.3 Rheumatoid nodule
- M06.4 Inflammatory polyarthropathy
- M06.8 Other specified rheumatoid arthritis
- M06.9 Rheumatoid arthritis, unspecified
- Psoriatic Arthritis (PsA): PsA This inflammatory autoimmune disorder that occurs in approximately 15-30 percent of people with psoriasis. It can also affect people without the skin symptoms of psoriasis. PsA causes joint pain, stiffness and swelling as well as overproduction of skin cells. The symptoms of psoriatic arthritis can affect any part of the body. Though PsA typically affects the distal joints in the fingers and toes, it can also affect the spine (spondylitis), sacroiliac joint, knees, wrists, elbows, and ankles. The ICD-10 codes for PsA are in the range of L40.50-L40.59.
- L40.0Psoriasis vulgaris
- L40.8Other psoriasis
- L40.9Psoriasis, unspecified
- L40.50Arthropathic psoriasis, unspecified
- L40.51Distal interphalangeal psoriatic arthropathy
- L40.52Psoriatic arthritis mutilans
- L40.53Psoriatic spondylitis
- L40.59Other psoriatic arthropathy
- Juvenile Arthritis (JA): About 300,000 kids and teens in the United States have juvenile arthritis, also known as pediatric rheumatic disease. Most types of JA are characterized by joint inflammation, swelling, pain and tenderness, but some types have few or no joint symptoms or only affect the skin and internal organs. Researchers believe JA is likely caused by certain genes when activated by a virus, bacteria or other external factors. Some relevant codes in the ICD-10 code range for JA M08-M09 are:
- M08.86 Other juvenile arthritis, knee
- M08.87 Other juvenile arthritis, ankle and foot
- M08.9 Juvenile arthritis, unspecified
- M08.91 Juvenile arthritis, unspecified, shoulder
- M08.92 Juvenile arthritis, unspecified, elbow
- M08.93 Juvenile arthritis, unspecified, wrist
- M08.941 Juvenile arthritis, unspecified, right hand
- M08.95 Juvenile arthritis, unspecified, hip
- M09 Juvenile arthritis in diseases classified elsewhere
Impact of Arthritis on Daily Life
The symptoms of arthritis range from joint pain, swelling, reduced mobility and physical weakness to general fatigue, trouble sleeping and exhaustion. All of these symptoms can greatly affect daily activities and overall wellbeing. As it is difficult to predict the symptoms, living with arthritis is tough. RA causes stiff and painful joints in the morning, making it difficult to get up and start the day. Everyday tasks like cooking, laundry, cleaning, gardening, and recreational activities can become a challenge as the disease progresses.
Diagnosis and Treatment
Arthritis is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests. Early diagnosis (within 6 months of the onset of symptoms) allows the physician to begin treatment to slow or stop disease progression, such as damage to joints). Early diagnosis and effective treatments, particularly treatment to suppress or control inflammation, can help reduce the damaging effects of this chronic disorder. If conventional measures don’t help, doctors may suggest surgery. Surgical interventions include joint repair, joint replacement and joint fusion. The treatment approach for arthritis varies depending on the type.
In many cases, arthritis symptoms can be reduced with lifestyle changes such as weight management, exercise, and heat and cold application. Using assistive devices can help protect joints and improve the ability to perform daily chores.
World Arthritis Day Initiatives
World Arthritis Day represents a platform for people and organizations across the globe to come together and make a meaningful impact on the understanding and management of RMDs. The goal is to inspire individuals with arthritis, along with their caregivers, families, and let them know they can get the support they need to face the challenges.
Celebrate World Arthritis Day! Participate in the various activities held to spread awareness about the importance of the recognition of arthritis symptoms and the vital role of early diagnosis in timely access to proper treatment. Take steps to promote a healthy lifestyle to support joint health. Focusing on prevention in RMDs is important to promote and maintain health.
As physicians strive to ease the struggles of people fighting this chronic, debilitating disease, outsourcing medical billing is a practical way to submit accurate claims. A pain management medical billing company can help providers report diagnosis and treatment correctly and ensure optimal reimbursement.