Here are the stories our MDedge editors across specialties think you need to know about today:
Answers to your top telehealth coding questions
How long can we continue using telehealth? How do I select a level of office visit? How do I bill for behavioral health services if I am not able to conduct in-person visits?
Our coding expert has fielded these and other questions from physicians ever since the Centers for Medicare & Medicaid Services expanded use of telehealth during the COVID-19 emergency. Find the answers to these questions and get more expert tips on how to code properly to miximize reimbursement.
Asymptomatic COVID-19 spread
A WHO official has stated that it appears to be “rare” that an asymptomatic individual can pass SARS-CoV-2 to someone else.
“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” Maria Van Kerkhove, PhD, WHO’s COVID-19 technical lead and an infectious disease epidemiologist, said June 8 at a news briefing from the agency’s Geneva headquarters.
This announcement came on the heels of the publication of an analysis in the Annals of Internal Medicine, which suggested that as many as 40-45% of COVID-19 cases may be asymptomatic. In this paper, the authors, Daniel P. Oran, AM, and Eric J. Topol, MD, of the Scripps Research Translational Institute in La Jolla, Calif stated: “The likelihood that approximately 40%-45% of those infected with SARS-CoV-2 will remain asymptomatic suggests that the virus might have greater potential than previously estimated to spread silently and deeply through human populations.” Read more.
Biologics and melanoma risk
New data suggest patients taking biologics for inflammatory bowel disease, rheumatoid arthritis, or psoriasis may have an increased risk of melanoma, but the association was not statistically significant in a systematic review and meta-analysis.
The study, published in JAMA Dermatology, assessed melanoma risk in 34,029 patients receiving biologics and 135,370 patients receiving conventional systemic therapy for IBD, RA, or psoriasis, using data from seven cohort studies.
The researchers analyzed the pooled relative risk across all studies. Compared with patients who received conventional systemic therapy, there was a nonsignificant association with risk of melanoma in patients with psoriasis (hazard ratio, 1.57), RA (pooled relative risk, 1.20), and IBD (pRR, 1.20).
Previous studies that have found an increased risk of melanoma in patients on biologics for these three conditions have “typically used the general population as the comparator,” the investigators noted. There is a large amount of evidence that has established short-term efficacy and safety of biologics, compared with conventional systemic treatments, but concerns about longer-term cancer risk associated with biologics remains a concern. “We advocate for more large, well-designed studies of this issue to be performed to help improve certainty,” the researchers said.
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