How to Code Rheumatoid Arthritis Medical Coding Tips
Alicia: Q: Rheumatoid arthritis. The abbreviationfor that is RA. You noticed I put the HCC on here. This is code 714.0 HCC 38, and ithas RxHCC of 41. What should a coder know about RAé A: There are lots of things about RA thatyou should know especially when you're doing HCC coding, since we've talked about it. You'vegot to be able to back up that the person has RA. With HCC coding, the just can'tlist patient has RA. You have to be able to show that's being treated. Once you have RAyou don't get rid of it, but it has to be shown that it's being treated.
What is RAé It's arthritis or polyarthritis:atrophic, rheumatic (chronic). This is different than juvenile rheumatoid arthritis. Notice that quot;use additional code to identifythe manifestationquot;é That's something to pay attention. Don't ever forget that. In this description about it, RA is reallyan autoimmune disease. It usually affects the synovial lining of the joints. You'veever heard of synovial fluidé Like, if a person has a bad knee or something, it swells up,and they say they went and had it drained. That's synovial fluid.
It comes in three stages: first, they'll haveswelling and pain. They'll get warmth, they'll be real hot and stiff around the joint. Then,they started getting division of new cells and stuff, so it starts increasing and theystart having problems and you get the synovium starts to thicken, and that's when you startseeing people with their fingers real crooked and curled. Their knuckles will get bumpson them and stuff. You can really wreak havoc on your extremities, your hands and your feetand your knees as water works on. It gets into the cartilage. Pain is the main thing;you've got a lot of pain. That's one of the treatments is they're treating the pain. Thejoint deformity, the instability of the joint
too, and it gets to where you just can't function.You can't move the joint because it's so stiff and hard. RA commonly begins in a small jointso usually in the hands and in the wrist and it usually happens bilaterally.It always affects both sides, both joints. There are other physical symptoms that you'llsee. When you're coding that, that means you want to look at the review of body systemsthat the does because he will probably mention that. Look in the musculoskeletalsection. Static audio That shows you the deformity;look at how those knuckles are deformed. You get pain mostly in the morning, stiffness,or if you sat down for a long time. You can
even run a fever, muscle aches and stuff,make you feel like you've got flu. Let's see cartilage, bone, and ligament damageoccurs in the advance stages. You can imagine, you saw that person's hand, the static audio.but it can affect the lungs and the heart. Boyd: Alicia, we lost you a lot. For the last30 seconds we lost you there. Alicia: OK. I'll back up. Not only can it affect, give you flulikesymptoms and you can run a fever, but it also can affect your heart and your lungs. Mostpeople don't realize that, but it will. So, if a person, if the is taking specialcare with a person with RA and he mentions
their lungs or he mentions their heart, thatcan be documentation to support the current RA condition. Now, RA usually happens in peoplebetween the age of 30 and 50, but it can afflict children and men more severely than women,I don't know why. Laureen: quot;What can be done about rheumatoidarthritisé A particular genetic marker in white blood cells, HLADR4, puts certain peopleat increased risk for RA. The immune system in people with RA mistakes the body's ownhealthy tissue for foreign invaders and attacks it. Some people also have an increase in rheumatoidfactor antibody that helps direct the production of normal antibodies. It is also believedthat RA may be triggered by an abnormal response
Osteoarthritis osteoarthritis early mortality
Osteoarthritisâ€¦ is it deadlyé Nextâ€¦ Is painful knee and hand osteoarthritis inwomen associated with excess mortalityé Reported in Medical News Today, research lookingat risk of early mortality of British middleaged women and osteoarthritis was presented atthe World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. It shows thatany painful knee osteoarthritis is strongly associated with early overall and cardiovascularmortality. Interestingly these findings are independent to most of the known risk factorslinked with early mortality. The study was based on the data from the Chingford Study.
Comment: Not just a source of pain and riskfor joint replacement anymore. Now, it is a risk factor for heart disease and earlydeath.