Observing National Diabetes Month in November

Observing National Diabetes Month in November

Based in the U.S, Outsource Strategies International (OSI) is a reputable and experienced billing and coding company specialized in providing medical billing and coding services for medical practices, clinics, hospitals and individual physicians.

In today’s podcast – Meghann Drella, one of our Senior Solutions Manager discusses about the significance of observing “National Diabetes Month” in November.

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Hello and welcome to our podcast series. My name Is Meghann Drella and I am a Senior Solutions Manager here at Outsource Strategies International. Today, I will be discussing National Diabetes Month.

00:12 – US Statistics on Diabetes

Diabetes is one of most common chronic conditions in the U.S. About 34.2 million Americans, just over 1 in 10, have diabetes, according to the National Diabetes Statistics Report, 2020 released by the Centers for Disease Control and Prevention (CDC). Diabetes is the seventh-leading cause of death in the U.S., accounting for more than 79,000 deaths annually. It is also one of the most expensive chronic conditions in America.  A study by the American Diabetes Association (ADA) reported the estimated total financial cost of diabetes mellitus in the United States is $327 billion, which includes $237 billion in direct medical costs and $90 billion in reduced productivity.

00:53 – Significance of National Diabetes Month

Observed each year in November, National Diabetes Month focuses on educating people about diabetes and their risks for the condition as well as encouraging those with diabetes to talk about their experiences and “awaken the world”. This has become even more important today as having diabetes increases the risks of getting serious complications from COVID-19, according to the ADA.

01:13 – Introduction to Diabetes

Diabetes occurs when the body’s ability to produce or use insulin is impaired, leading to a rise in the level of blood sugar or glucose. Excess sugar in the blood can cause serious complications such as kidney failure, heart attacks, stroke, amputations and blindness, and is linked to an increased risk for several cancers.

01:31 – Three Types of Diabetes

There are three types of diabetes: type 1, type 2 and gestational diabetes. In type 1 diabetes, the body’s immune system attacks the cells of the pancreas that produce insulin. The result is that the body produces little to no insulin. Type 2 is the most common type of diabetes, and occurs when the body develops insulin resistance and also loses its ability to produce insulin.   The CDC estimates that approximately 90-95% Americans have type 2 diabetes. The third type, gestational diabetes, develops during pregnancy. High blood sugar caused by gestational diabetes can affect the mother’s health and lead to birth defects in the growing baby. Though the condition can be controlled through diet and exercise, women diagnosed with gestational diabetes face a risk of developing diabetes at a later stage in their life.  Gestational diabetes affects about 3 in 100 to 9 in 100 pregnant women, according to Stanford Children’s Health.

02:27 – Secondary Diabetes

Secondary diabetes is diabetes caused by another medical condition. Conditions that can cause diabetes are: cystic fibrosis, hemochromatosis, polycystic ovary syndrome (PCOS), pancreatectomy, chronic pancreatitis, pancreatic cancer, Cushing’s syndrome, and glucagonoma. Drug-induced diabetes is diabetes that is caused by taking certain medications such as corticosteroids, thiazide diuretics, and beta-blockers.

02:58 – Diagnosing Diabetes

Of the 34.2 million Americans living with diabetes, 88 million, or about 1 in 3, have prediabetes. In prediabetes, glucose levels are high, but not high enough to confirm a diagnosis of diabetes. According to the CDC, 90-95 percent people have type 2. Many people with prediabetes are not aware of their condition.

The tests used to diagnose diabetes are the fasting plasma glucose (FPG) test, which requires overnight fasting, and the hemoglobin A1C (HbA1c) test which gives average blood glucose levels over a period of weeks/months. A random plasma glucose (RPG) test can be used to test for diabetes at any time, with no need for fasting overnight.

03:41 – Treatment and Management of Diabetes

There is no cure for Type 2 diabetes. Some people are able to manage the condition with a proper diet, exercising regularly, and maintaining a normal weight. However, others may need oral or injectable medication treatments to keep blood sugar levels stable.  Treatment depends on the type of diabetes that the patient has. Typically, diabetes treatment begins with prescribing oral metformin (Glucophage). Depending on the patient’s condition, various class drugs may also be included in the treatment plan. Some patients need insulin injections — which work in the same way as the insulin produced by the body — to lower blood sugar levels.

The main goals of treatment for diabetes mellitus are to address the symptoms and to prevent complications from occurring. Continuous glucose monitoring (CGM) plays a crucial role in evaluating the efficacy and safety of treatment in many patients with type 1 diabetes as well as in patients with type 2 diabetes who are under intensive insulin therapy. However, for treatment to be effective, associated conditions like glycemia, lipids, blood pressure are also addressed. In addition to medical nutrition therapy, exercise, and pharmacologic therapy, diabetes management interventions may include weight loss surgery, intensive lifestyle modification, and psychological interventions.

05:00 – Preventing Diabetes

People at risk need to be educated on how to prevent diabetes. Patients with diabetes should be educated about the condition and encouraged to adhere to a proper treatment plan. The importance of diet and exercise needs to be stressed as these measures can have a significant impact in controlling the disease and improving quality of life. The guidelines issued by the American College of Clinical Endocrinologists recommends the following measures for the prevention of type 2 diabetes mellitus in patients at risk:

  • Weight reduction
  • Proper nutrition
  • Regular physical activity
  • Cardiovascular risk factor reduction, and
  • Aggressive treatment of hypertension and dyslipidemia

05:39 – ADA’s Standards of Medical Care in Diabetes 2020

The ADA’s Standards of Medical Care in Diabetes has new and revised diabetes treatment recommendations and guidelines for screening, diagnostic, and therapeutic actions that are known or supposed to have a favorable impact on health outcomes of patients with diabetes. Diabetes mellitus requires long-term medical care to reduce the risk of devastating complications and to manage them if they occur. This also applies to COVID-19. The ADA has confirmed that the risk of getting very sick from COVID-19 is likely to be lower if diabetes is well-managed.

I hope this helps, but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you for joining me, and stay tuned for my next podcast!

Observing National ADHD Awareness Month in October

Observing National ADHD Awareness Month in October

An US based medical billing and coding company with vast experience in the field, Outsource Strategies International (OSI) provides revenue cycle management solutions for various medical specialties.

In today’s podcast, Meghann Drella, one of our Senior Solutions Managers, discusses the significance of observing October as “National Attention Deficit Hyperactivity Disorder (ADHD)” Awareness month in the United States.

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Hello and welcome to our podcast series. My name Is Meghann Drella and I am a senior solutions manager here at Outsource Strategies International. Today, I will be discussing how October is observed as “National Attention Deficit Hyperactivity Disorder (ADHD) Awareness” month in the United States.

0.16 – Introduction to ADHD Awareness Month

Sponsored by a coalition of organizations like ADHD Coaches Organization (ACO), Attention Deficit Disorder Association (ADDA) and the Children and Adults with Attention-Deficit/Hyperactivity (CHADD), this campaign aims to spread awareness about attention deficit hyperactivity disorder, remove the stigma and highlight the available resources that help individuals and families to live successfully with ADHD. It aims to focus on the latest research and clinical studies with the goal of bringing more effective treatments.

0.46 – ADHD and Causes

A common neurodevelopmental disorder affecting both children and adults around the globe, ADHD can cause above-normal levels of hyperactive and impulsive behaviors. Also known as attention deficit disorder (ADD), the condition is characterized by behavioral problems related to attention, impulsivity and/or hyperactivity that can interfere with the person’s day-to-day functioning or development. The condition can continue through adolescence and adulthood. The exact factors that cause attention deficit hyperactivity disorder are unknown. However, genetics and neurobiological factors are believed to play an active role. If left untreated, ADHD can lead to several serious consequences. Neuropsychologists, clinical psychologists, psychiatrists and other specialists offering treatment to patients with this behavioral disorder must know the correct medical codes to report the condition correctly.

1.39 – Significance of ADHD Campaign and Statistics

The 2020 month-long campaign aims to celebrate the progress made in ADHD education and advocacy. It is a novel platform that helps recognize the work that still needs to be done and raise awareness about the importance of early diagnosis and treatment. Reports suggest that approximately 7.2 percent of children worldwide have ADHD, while about 3.4 percent of adults are estimated to have diagnosed or undiagnosed ADHD. It is estimated that, in the United States, approximately 9 percent of children have been diagnosed with ADHD and 4 percent of adults are estimated to have either diagnosed or undiagnosed ADHD. For about half of the children with ADHD, the condition continues to clearly exhibit symptoms into adulthood, presenting a range of challenges across the person’s lifespan. In fact, boys are more than twice as likely as girls to have ever been diagnosed with ADHD.

2.33 – Types of ADHD and Symptoms

There are three different types of ADHDs which include – predominantly inattentive, predominantly hyperactivity-impulsive, and a combination of both. People with predominantly inattentive type of ADHD have extreme difficulty focusing, finishing tasks, and following instructions. On the other hand, people with predominantly hyperactivity-impulsive type depict primarily hyperactive and impulsive behavior like – fidgeting, interrupting people while they’re talking, and not being able to wait their turn. However, a combination of both these types displays both inattentive and hyperactive symptoms. Common symptoms include – trouble focusing or concentrating on tasks, being forgetful about completing tasks, easily being distracted, having difficulty sitting still, trouble coping with stress, interrupting people when talking, and problems following through and completing tasks.

3.28 – Diagnosis and Treatment

There is no single test that can definitely diagnose ADHD. Generally, the diagnosis may begin with an interview and detailed medical history evaluation to obtain relevant information about changes in past and present behavior patterns over the last six months. Physicians may gather information from friends and family members and ask questions to establish a behavioral history to obtain the best likely diagnosis. This may include questions about how the patient functions at home, school or work. Patients will be asked to fill out a checklist with symptoms. In addition, a detailed physical examination will be performed to rule out symptoms of other medical conditions resembling those of ADHD. Patients may need to undergo different types of psychological tests to rule out the presence of co-existing conditions like anxiety or depression. Depending on the extent of diagnosis, patients may take an appointment with a psychiatrist or neurologist for detailed analysis and treatment. One of the most important aspects of treatment is determining the type of ADHD a person is suffering from. Treatment approaches for attention deficit disorders (ADDs) include a combination of medications and behavioral therapy. Prescription medications like psycho stimulants, antidepressants, and non-stimulant drugs can help patients with ADD to stay on-task and focused.

4.48 – Clinical Criteria and Guidelines for Diagnosing ADHD

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides the clinical criteria and guidelines for diagnosing ADHD. To make a diagnosis, children should have six or more symptoms of the disorder present. Adolescents 17 and older, and adults should have at least five of the symptoms. There must also be evidence that symptoms began before the age of 12 years. The diagnostic tests and other treatment procedures administered for ADHD must be correctly documented using the right medical codes.

5.21 – History and Theme of ADHD Awareness Month

ADHD Awareness Month was first initiated in the year 2004 as a collaboration of multiple organizations such as ACO, ADDA and CHADD. The aim of the campaign is to raise awareness of ADHD by providing information that is reliable. The theme of the 2020 campaign is – “Common Questions, Reliable Answers”. The theme aims to collect the top questions about ADHD to be answered by internationally respected researchers and ADHD experts and professionals. These answers will be shared on the ADHD awareness website and other social platforms.

I hope this helps, but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank for joining me, and stay tuned for my next podcast!

Learn about Rheumatic Disease Awareness Month and The Condition’s ICD-10 Codes

Learn about Rheumatic Disease Awareness Month and The Condition’s ICD-10 Codes

A U.S. based medical billing outsourcing company with extensive experience, Outsource Strategies International (OSI) provides efficient medical coding services for individual physicians, medical practices, clinics, and hospitals. OSI provide accurate diagnosis and documentation which are crucial for error-free billing and optimal reimbursement.

In today’s podcast, Natalie Tornese, one of our Senior Group Managers, discusses about Rheumatic Disease and its awareness month which is observed in September.

Read Transcript

Hello everyone and welcome to our podcast series. My name is Natalie Tornese and I’m a Senior Group Manager at Outsource Strategies.

00:08 Introduction of Rheumatic Disease Awareness Month

September is Rheumatic Disease Awareness Month. It is designated as Rheumatic Disease Awareness Month by the American College of Rheumatology to draw attention to these painful autoimmune and inflammatory diseases that affect about 54 million or 1 in 4 American adults. Rheumatic diseases are considered the leading cause of disability in the United States. Awareness about symptoms and risk factors, early diagnosis and specialized treatment can help people better manage their condition and improve their quality of life.

00:42 Common Types and Prevalence of Rheumatic Disorders

Rheumatic diseases cause the immune system to attack the joints, bones, cartilage, tendons, ligaments, and muscles. They can also damage the vital organs, including the lungs, heart, nervous system, kidneys, skin and eyes. There are hundreds of different rheumatic diseases. The most commonly known types are rheumatoid arthritis, osteoarthritis, lupus, psoriatic arthritis, Sjogren’s syndrome, gout, and scleroderma.

While the risk of gout, osteoarthritis, and rheumatoid arthritis increases with the age, these conditions can also affect people ages 20-40. Pediatric rheumatic diseases affect nearly 300,000 children in the United States, and for many, symptoms may persist even in adulthood. Affordability is a major concern for individuals with rheumatic diseases. Sadly, nearly 60 percent of patients being treated for a rheumatic disease reported that they had difficulty affording their medications or treatments in the past year.

01:47 Importance of Early Diagnosis and Treatment

Lack of awareness about rheumatic disease increases the risk of longer-term pain and damage of not only the joints but also various organs and body systems. Autoimmune rheumatic diseases causes the immune system to attack the body’s healthy tissues.

It is crucial that people learn to recognize the symptoms of rheumatic disease and get timely treatment. Recent studies suggest that patients with autoimmune rheumatic disease may be at higher risk for severe COVID-19 disease than the general population.

The Rheumatic Disease Awareness Month is a national campaign dedicated to drawing attention to the more than 100 conditions that come within the sphere of rheumatic disease. Rheumatic disease symptoms can be difficult to recognize and may be just considered as aches and pains usually associated with aging.  Unfortunately, many people live with their condition for years before they get a correct diagnosis and treatment.

02:51 Goal of Rheumatic Disease Awareness Month

The goal of Rheumatic Disease Awareness Month is to educate people about the risk factors, treatment options, economic impact, and lifestyle or healthcare challenges associated with it, and importantly, what symptoms to look for and when to consult a rheumatology specialist.

03:10 Causes and Symptoms of Rheumatic Conditions

Rheumatic diseases are believed to be triggered by a combination of hereditary and environmental factors, though it is difficult to determine the cause of the condition in a particular individual. Many of these conditions occur when the immune system gets “confused” and attacks your own joints, muscles, bones and organs. Examples of autoimmune diseases include rheumatoid arthritis , lupus, and vasculitis. Factors that increase risk of developing rheumatic disease include:

  • Your sex, as women are more likely than men to develop rheumatic diseases such as Rheumatoid Arthritis, Scleroderma, Fibromyalgia, and Lupus.
  • Age: Rheumatic diseases can occur at any age, but it most commonly begins in middle age.
  • Family history is associated if a member of your family has rheumatic disease, you may have an increased risk.
  • Smoking:Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing disease. It also appears to be associated with greater disease severity.
  • Environmental exposures: Although poorly understood, some exposures such as asbestos or silica may increase the risk of developing rheumatoid arthritis. Emergency workers exposed to dust from the collapse of the World Trade Center are at higher risk of autoimmune diseases such as rheumatoid arthritis.
  • Higher levels of estrogen may contribute to the development of the disease.
  • And high levels of stress may also cause symptoms to flare up.

04:46 Signs and Symptoms of Rheumatic disorders

Rheumatic diseases are generally chronic, and symptoms can worsen over time and lead to severe complications. Common signs and symptoms of rheumatic disease include:

  • Chronic and debilitating joint pain
  • Inflammation indicated by joint swelling, tenderness, warmth and redness
  • Morning stiffness
  • Muscle pain
  • Pain in the neck, spine, or back
  • Numbness and tingling in the hands and feet
  • Swelling
  • Difficulty moving the joints
  • Joint deformity
  • Fatigue
  • Eye inflammation, infections, or dryness
  • And rashes and sores

05:24 Importance of Early and Timely Diagnosis of Rheumatic Disease

 Timely diagnosis can prevent the condition from becoming more serious or causing more severe symptoms. Also, having one rheumatic disease can put a person at a risk of developing others. Initiating treatment early can slow the progression of rheumatic disorders and prevent irreversible joint or organ damage, and improve chances of remission. This all depends on early diagnosis.

The sooner a person is diagnosed and referred to the correct specialist to receive proper treatment, the better a patient’s chances are of managing their disease and enjoying a fuller, healthier life.

06:01 Types of Rheumatic Disease

The types of rheumatic diseases are as follows:

 06:06 Ankylosing Spondylitis: This is a chronic inflammatory disease that can cause some small bones of the spine to fuse, affecting movement and leading to stiffness, pain and hunching. Other complications include breathing difficulties, eye inflammation, compression fractures, and heart problems.  Men are at greater risk of developing ankylosing spondylitis than women.

06:33 Bursitis: This painful condition affects the bursae, the small fluid-filled sacs that serve as a cushion for the bones, tendons and muscles near the joints. The bursa become inflamed when there is too much friction. The most common areas where inflammation occurs are the shoulder, elbow, hip and knee.  In addition to pain, symptoms can also include stiffness of the affected joint, swelling, warmth and redness at the site, along with tenderness, and fever.

07:07 Crohn’s Disease is a chronic, inflammatory bowel disease that appears early in life, typically at age 15. Different people experience inflammation caused by Crohn’s disease in different areas of the digestive tract, and the disease can progress deep into the layers of affected tissue. Symptoms include pain, abdominal cramps, diarrhea, mouth sores, fever, weight loss, and anemia. Crohn’s disease can also lead to complications such as colitic arthritis, inflammation of the tissues around the bile ducts, kidney stones, fistulas and urinary tract problems.

07:42 Gout is a form of inflammatory arthritis that results in painful, swollen joints. It is caused by monosodium urate crystal deposits in the joints which result from excessive uric acid in the body. Gout mostly affects the joint at the base of the big toe. Common symptoms include severe sudden pain, chills, fever, and general malaise.

08:06 Juvenile Idiopathic Arthritis, JIA is a group of conditions that causes joint inflammation in children. Though children often outgrow this autoimmune disorder, it can stunt bone development in the growth stage. There are different types of JIA, distinguished by the number of joints affected, their signs and symptoms, the results of laboratory tests, and family history. Symptoms include swollen, stiff, and painful joints, usually in the morning, eye inflammation, fatigue, and appetite loss. Systemic JIA can cause high fever and rash and swollen lymph nodes.

08:48 Osteoarthritis is the most common type of arthritis. It is actually not considered a rheumatic disease as it is caused by the natural wearing down of the joint’s cartilage over time, as opposed to causing inflammation. OA causing stiffness, pain and loss of movement in the joint. Though the condition can damage any joint OA usually affects the joints in the hands, knees, hips and spine. Staying active, maintaining a healthy weight and some treatments can help manage the OA symptoms, slow disease progression and help improve pain and joint function.

 09:21 Osteoporosis causes bones to become weak and brittle due to a decrease in bone mass and density. Bone is constantly broken down and replenished. Osteoporosis occurs when the body stops creating new bone to replace the loss of old bone. The condition affects more than 10 million Americans. Up to 1 in 2 women will break a bone due to osteoporosis, according to the Johns Hopkins University School of Medicine.

 09:58 Polymyalgia Rheumatica is an inflammatory disorder that usually affects people over 65, causing muscle pain and stiffness in the shoulders, neck, hips, and lower back. It can occur along with giant cell arteritis, another inflammatory disease of the arteries that causes headaches, vision difficulties, jaw pain and scalp tenderness.

10:21 Polymyositis is an inflammatory rheumatic disease that can affect the whole body. Signs and symptoms usually develop gradually over time, causing muscle weakness and ultimately, disability.

10:33 Psoriatic Arthritis is a chronic disease that usually occurs in people with skin psoriasis. It can affect just one joint, several joints or multiple joints. It typically affects the joints at the end of the toes and fingers and the back of the sacroiliac joints of the pelvis. Early accurate diagnosis is critical as research suggests that persistent inflammation from psoriatic arthritis can ultimately damage the joints.

10:57 Rheumatoid Arthritis is the most common type of autoimmune arthritis. It is estimated that about 1.3 million people in the US are living with RA. This chronic condition is characterized by pain and swelling in the wrist and small joints of the hand and feet. It can cause long-term joint damage, with chronic pain, loss of function and disability. Fortunately, early treatment for RA can improve symptoms and help people live an active life.

11:27 Scleroderma is a rare condition caused by overproduction of collagen in the skin. It is characterized by thickening and tightening of the skin and inflammation and scarring in many areas of the body. Systemic scleroderma, the most serious form of the disease, can also affect the lungs, kidneys, heart, intestinal system and other areas.

 11:50 Sjögren‘s Syndrome is an autoimmune disease that causes dry eyes and a dry mouth. It typically affects older women. Many patients develop Sjögren’s syndrome as a complication of rheumatoid arthritis or lupus. In some patients, the disease may cause lung problems, abnormal liver and kidney function, skin rashes, and neurologic problems.

12:13 Spondyloarthropathies are a group of rheumatic diseases that cause arthritis. They mainly cause pain and inflammation in the spine. Some forms also affect the arms and legs, hands and feet, hips, shoulders and knees.  Axial spondyloarthritis can progress into ankylosing spondylitis, may be associated with eye problems, skin rashes and mouth sores.

12:39 and then there is Lupus: Lupus causes widespread inflammation in the body and affects the joints, muscles, skin, blood vessels and even kidneys.  It is believed to be caused by a combination of genetics, hormones and environmental factors. It is more common among women and about 20 percent of people with lupus develop the disease before age 20.

13:00 Tendinitis or bursitis involves inflammation of the tendons in the shoulder, elbow, wrist, hip, knee and ankle. It is usually the results of overuse or repetitive stress, but can also occur as a result of a sudden intense injury or a pre-existing rheumatic condition. Tendinitis symptoms include pain, tenderness and restricted mobility.

13:23 Diagnosing Rheumatic Disease

 Diagnosing rheumatic disease begins with a physical exam, discussion of symptoms, and questions about present and past health. The rheumatologist will examine the patient’s range of motion and reflexes and check for conditions like swollen glands and eye inflammation. Laboratory tests may be recommended to detect various signs of inflammation and test for inflammatory markers. Imaging tests can show progression of the disease in the joints.

Early and rapid diagnosis is an important prerequisite for managing rheumatic disease. However, while some conditions like gout are usually easy to diagnose, some autoimmune rheumatic diseases are challenging to detect during the early stages.

Another thing that makes diagnosis difficult is that in the early phases, rheumatic illnesses will not present the way that they’re described in textbooks. For example, in patients who have rheumatoid arthritis, the early symptoms may be just a little morning stiffness and the typical exam may not reveal much.

The elements that go into diagnosing a rheumatic disease are a careful detailed history and a very good detailed physical, supported by both laboratory studies and imaging studies.

14:36 Treatment options of rheumatic diseases

 As rheumatic diseases are chronic conditions, the focus of treatment is to ease the symptoms, reduce inflammation, slow progression, and/or achieve remission. Treatment would depend on the patient’s condition. Medications for musculoskeletal disorders include Oral and topical analgesics, corticosteroids to address inflammation, disease-modifying anti-rheumatic drugs including JKI inhibitors, injections into a joint or the soft tissues, physical therapy, chiropractic treatment, and surgical options. Individual response to treatments for arthritis may vary.

15:16 Billing and Coding Rheumatic Disease

In order to get paid, physicians should report a valid ICD-10 code that informs payers the reason for services. Medical necessity generally determines the payment. I will include a transcript along with this podcast with all associated ICD 10 codes related to this condition.

(ICD 10 codes related Rheumatic Disease

  1. Ankylosing spondylitis – M45.
  2. Arthralgia (joint pain) – M25.5
  3. Arthopathy – M12.8
  4. Baker’s Cyst – M71.2
  5. Bechet’s syndrome – M35.2
  6. Bursitis knee – -M70.5
  7. Bursitis olecranon – M70.2
  8. Carpal tunnel syndrome – G56.0
  9. Chronic pain – G89.29
  10. Costochondritis – M94.0
  11. Cushing syndrome, other – E24.8
  12. De Qervain’s tenosynovitis – M65.4
  13. Effusion – M25.4
  14. Elevated CRP – R79.82
  15. Elevated SED rate – R70.0
  16. Enteropathicarthopathies, multiple sites- M07.69
  17. Fibromyalgia – M79.7
  18. Gout, acute idiopathic – M10.0
  19. Gout, chronic, idiopathic – M1A,0
  20. Juvenile rheumatoid arthritis, Still’s disease NOS – M08.20
  21. Lupus erythematous NOS – L93.0
  22. Lupus SLE, NOS – M32.9
  23. Myalgia – M79.1
  24. Osteoarthritis primary – MlS.0
  25. Osteoarthritis bilateral, hip – M16.0
  26. Osteoarthritis unilateral, hip – M16.1
  27. Osteoarthritis bilateral, knee – M17.0
  28. Osteoarthritis unilateral, knee – M17.1
  29. Osteoarthritis bilateral, first carpometacarpal joint – M19.0
  30. Osteoarthritis unilateral, first carpometacarpal joint – M19.1
  31. Osteopenia -M85.89
  32. Osteoporosis w/pathological fracture, age related – M80.0l
  33. Osteoporosis w/o pathological fracture, age related – M81.0
  34. Polymyalgia rheumatica – M35.3
  35. Pseudo gout – Mll.29
  36. Psoriatic arthritis – L40.50
  37. Psoriatic spondylitis – L40.53
  38. Raynaud’s syndrome w/o gangrene -173.00
  39. Reactive arthritis (Reiter’s) – M02.3
  40. R/ Aw/rheumatoid factor w/o organ or systems involvement – M05.7
  41. R/A w/o rheumatoid factor- M06.0
  42. Sjogrens disease – M35.0
  43. Spondylosis with myelopathy- M47.1
  44. Stills disease, adult onset – M06.1
  45. Trigger finger – M65.3
  46. Wegener’s granulomatosis – M31.3
  47. Drug monitoring long term use – 279.899
  48. Drug monitoring – current (NSAIDS)- Z79.1
  49. Drug monitoring – current (steroids) – 279.52
  50. Pregnant state – Z33.1 )

Along with choosing the correct ICD-10 code, physicians should ensure relevant documentation in the medical chart to support the level of the ICD-10 code. Based on the diagnosis, documentation should specify:

  • If the condition is chronic or acute
  • The etiology of the disease
  • The anatomical site is affected
  • And the side of the body that is affected

If the provider has not established a related, definitive diagnosis, codes that describe signs and symptoms can be reported. The patient’s signs and symptoms should be clearly recorded in the medical record documentation. This will allow medical coding service providers to code to the highest level of certainty based on the known signs and symptoms.

 16:16 Ensure Correct Diagnosis and Appropriate Treatment by a Rheumatologist

Rheumatologists specialize in diagnosing and treating musculoskeletal diseases and autoimmune rheumatic diseases. People who experience joint pain usually first consult their PCP, as inflammatory arthritic diseases can progress quickly, the PCP may initiate early tests prior to referral to a rheumatologist.

Rheumatic Disease Awareness Month is dedicated to increasing the public’s understanding and awareness about the prevalence or severity of rheumatic diseases.  The ACR’s Simple Tasks platform encourages patients to educate their close family members, friends, and even children about their disease. This can go a long way in addressing any potential confusion and anxiety on their end as well as helping them understand how the disease impacts the patient’s day to day life.

I hope this helps. But always remember that documentation and a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

2019 American Diabetes Month – November

2019 American Diabetes Month – November

Based in U.S., Outsource Strategies International (OSI) have years of experience in providing accurate HIPAA-compliant medical billing and coding services for physician offices, clinics, multi-specialty practices, dental clinics and group practices.

In today’s podcast, Meghann Drella, one of our Senior Solutions Managers, discusses the American diabetes month – November.

Read Transcript

Hello and welcome to our podcast series!

My name is Meghann Drella and I am a Senior Solutions Manager here at Outsource Strategies International. Today I will be discussing diabetes for American diabetes month.

Observed in November, “American Diabetes Month (ADM)” aims to generate widespread awareness about diabetes and its associated symptoms, risk factors, and treatment options. An annual observance to draw attention to diabetes and its impact on millions of people in the United States and around the world is observed in November. Sponsored by the American Diabetes Association (ADA), the monthly campaign is an opportunity for local and regional advocates to team up and work with partners across the US to raise awareness about the types of diabetes, symptoms, risk factors, and promote healthy living.

Regarded as one of the leading causes of disability and death in the United States, diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. Glucose is vital for your health because it’s an important source of energy for the cells that make up your muscles and tissues. If left untreated, high blood sugar from diabetes can damage the nerves, eyes, kidneys, and other organs. The underlying cause of diabetes varies by type. Chronic diabetes conditions include Type 1 diabetes and Type 2 diabetes. Pre-diabetes (when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes) and gestational diabetes (which occurs during pregnancy but may resolve after the baby is delivered) are the two other types. However, these conditions can be effectively managed through a healthy lifestyle modification and medications to prevent further complications. Regular screening tests help in identifying the condition in its early stages and reversing the serious complications caused by the same.

According to the Centers for Disease Control and Prevention (CDC), diabetes is a chronic health problem in the United States, affecting 30.3 million people, as of 2018. It is estimated that 14 percent of U.S adults have diabetes – 10 percent are aware about the same and more than 4 percent remain undiagnosed. For the 2019 campaign, the diabetes community aims to bring attention to the severity of the problem through advocacy and awareness events, programs, and initiatives.

Generally, diabetes mellitus symptoms may depend and vary on how much your blood sugar is elevated. In some cases, people with pre-diabetes or Type 2 diabetes, may not experience any specific symptoms initially. However, in Type 1 diabetes, symptoms may appear quickly and be more severe. The general signs and symptoms include – increased thirst, weight loss, frequent urination, fatigue, blurred vision, irritability and slow-healing sores. However, as the disease progresses, the symptoms become more severe and potentially dangerous and these include – frequent infections, such as gum or skin infections and vaginal infections, dark patches on the skin, foot pain and feeling of numbness in your extremities or neuropathy.

As part of the event, the American Diabetes Association (ADA) is urging people to take a “60 seconds Type 2 Diabetes Risk Test” to find out whether they are at high or low risk of developing this condition. The test requires people to answer a series of questions about their weight, age, family history and other risk factors for developing this condition. Preventive steps are recommended for people who are at high risk of developing the condition. Incorporating healthy lifestyle changes can help slow or even stop the progressions to diabetes. A unique combination of healthy eating, regular physical activity and blood sugar monitoring plays an important role in regulating blood sugar levels and preventing further complications.

Diabetologists offering treatment for diabetes mellitus are reimbursed for their services. The diagnosis, screening tests and other procedures must be documented using the correct medical codes starting with E11 to E11.9.

As part of the campaign, healthcare centers, hospitals and other health systems across the US are planning to host a wide range of events like seminars, discussions, presentations and share information on social media to raise public awareness about diabetes. People are requested to raise their voice, mark their fist, and share their image via various social media platforms under the hashtag #CountMeInADA. You can become a volunteer and donate your time in helping the diabetic community. Organizations can also participate in this event by sharing photos and videos of their employees and their organization in action.

Join the American Diabetes Month celebrations this November. Take control of your health by making healthy lifestyle choices.

Thanks for joining me and please stay tuned for my next podcast!

September Observed as National Traumatic Brain Injury Awareness Month

September Observed as National Traumatic Brain Injury Awareness Month

Based in U.S., Outsource Strategies International (OSI) is an experienced provider of medical billing and coding services for diverse medical specialties.

September is National Traumatic Brain Injury Awareness Month. In today’s podcast, Meghann Drella, one of our Senior Solutions Managers, discusses the causes and symptoms of Traumatic Brain Injury.

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