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66HB0 Rheumatoid arthritis annual review
- N040.% Rheumatoid arthritis
N041. Felty's syndrome
N042.% Other rheumatoid arthropathy with visceral or systemic involvement (Excluding N0420 Rheumatic carditis (v27))
N047. Seropositive errosive rheumatoid arthritis
N04X. Seropositive rheumatoid arthritis, unspecified
N04y0 Rheumatoid lung
N04y2 Adult-onset Still's disease
Nyu11 [X]Other seropositive rheumatoid arthritis
Nyu12 [X]Other specified rheumatoid arthritis
Nyu1G [X]Seropositive rheumatoid arthritis, unspecified
Nyu10 [X]Rheumatoid arthritis with involvement of other organs or systems
- G5yA. Rheumatoid carditis
G5y8. Rheumatoid myocarditis
RA is a chronic disease with a variable course over a long period of time. Therefore, there is a need for regular monitoring to determine disease status, assess severity, efficacy and toxicity of drug therapy and identify co-morbidities or complications.
Patients with satisfactorily controlled established disease require review appointments for ongoing drug monitoring, additional visits for disease flares and rapid access to specialist care. RA and its treatment can also have a negative effect upon a patient’s quality of life. It is recommended that contractors review the following aspects of care with a patient:
• disease activity and damage, which may include requesting C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) or plasma viscosity test
• a discussion of DMARDS, if relevant
• the need for referral for surgery
• the effect the disease is having on their life, for example employment or education
• the need to organise appropriate cross-referral within the multi-disciplinary team.
As a minimum, it is advised that this review covers disease activity and damage, the effect of the disease upon the patient's life and whether they would benefit from any referrals to the multi-disciplinary team.
See indicator wording for requirement criteria.
Verification - NHS England may wish to review patient records to ensure that all essential elements of the review have been performed.
Prepared By Jean Keenan