Psoriatic Arthritis N059

Current RMA Instruments

Reasonable Hypothesis SOP

15 of 2021

Balance of Probabilities SOP

16 of 2021

Changes from previous Instruments


ICD coding
  • ICD-9-CM Codes: 696.0
  • ICD-10-AM Codes: M07.0, M07.3
Brief description

Psoriatic arthritis is a chronic inflammatory arthritis resembling rheumatoid arthritis.  It occurs in up to 30% of people with psoriasis, but may also occur in the absence of psoriasis.  In a person with an inflammatory arthritis and psoriasis the diagnosis of psoriatic arthropathy needs to be considered, but is not automatic.

Confirming the diagnosis

There are no specific diagnostic tests and a range of clinical presentations.  Diagnosis typically requires specialist opinion and is normally made on clinical grounds together with appropriate laboratory testing and imaging.  

The appropriate medical specialist is a rheumatologist.

Additional diagnoses covered by SOP
  • psoriatic arthropathy
Conditions excluded from SOP / differential diagnosis
  • Ankylosing spondylitis*
  • Arthritis associated with inflammatory bowel disease#
  • Gout*
  • Osteoarthritis*
  • Reactive arthritis*
  • Rheumatoid arthritis*

* another SOP applies

# non-SOP condition

Clinical onset

The condition presents with pain and stiffness in the affected joints. There is no particular pattern to the joints affected.  A history of psoriasis is present in about 70 percent of patients.

Clinical worsening

The course of the condition is variable but progressive joint damage is likely.  Various treatment options are available that can modify the course of the condition and slow progression.

 
 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/n-p/psoriatic-arthropathy-n059-m070m073

Last amended

Rulebase for psoriatic arthropathy

<h5><strong>Current RMA Instruments</strong></h5><table width="100%" border="1" cellspacing="1" cellpadding="0"><tbody><tr><td><p><a href="http://www.rma.gov.au/assets/SOP/2021/5544aec646/015.pdf&quot; target="_blank"><em><u>Reasonable Hypothesis SOP</u></em></a></p></td><td><p>15 of 2021</p></td></tr><tr><td><p><a href="http://www.rma.gov.au/assets/SOP/2021/15604dbcbd/016.pdf&quot; target="_blank"><em><u>Balance of Probabilities SOP</u></em></a></p></td><td><p>16 of 2021</p></td></tr></tbody></table><h5><strong>Changes from previous Instruments</strong></h5><h5><drupal-media data-entity-type="media" data-entity-uuid="c20a66e5-8452-459e-90be-ce42efe29366" data-view-mode="wysiwyg"></drupal-media><br><br><span>ICD coding</span></h5><ul><li>ICD-9-CM Codes: 696.0</li><li>ICD-10-AM Codes: M07.0, M07.3</li></ul><h5><strong>Brief description</strong></h5><p>Psoriatic arthritis is a chronic inflammatory arthritis resembling rheumatoid arthritis.  It occurs in up to 30% of people with psoriasis, but may also occur in the absence of psoriasis.  In a person with an inflammatory arthritis and psoriasis the diagnosis of psoriatic arthropathy needs to be considered, but is not automatic.</p><h5><strong>Confirming the diagnosis</strong></h5><p>There are no specific diagnostic tests and a range of clinical presentations.  Diagnosis typically requires specialist opinion and is normally made on clinical grounds together with appropriate laboratory testing and imaging.  </p><p>The appropriate medical specialist is a rheumatologist.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>psoriatic arthropathy</li></ul><h5><strong>Conditions excluded from SOP / differential diagnosis</strong></h5><ul><li>Ankylosing spondylitis*</li><li>Arthritis associated with inflammatory bowel disease<sup>#</sup></li><li>Gout*</li><li>Osteoarthritis*</li><li>Reactive arthritis*</li><li>Rheumatoid arthritis*</li></ul><p>* another SOP applies</p><p><sup>#</sup> non-SOP condition</p><h5><strong>Clinical onset</strong></h5><p>The condition presents with pain and stiffness in the affected joints. There is no particular pattern to the joints affected.  A history of psoriasis is present in about 70 percent of patients.</p><h5><strong>Clinical worsening</strong></h5><p>The course of the condition is variable but progressive joint damage is likely.  Various treatment options are available that can modify the course of the condition and slow progression.</p><h5> </h5><h5> </h5><p> </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/n-p/rulebase-psoriatic-arthropathy

Inability to obtain appropriate clinical management for psoriatic arthropathy

Current RMA Instruments

Reasonable Hypothesis SOP

15 of 2021

Balance of Probabilities SOP

16 of 2021

Changes from previous Instruments


ICD coding
  • ICD-9-CM Codes: 696.0
  • ICD-10-AM Codes: M07.0, M07.3
Brief description

Psoriatic arthritis is a chronic inflammatory arthritis resembling rheumatoid arthritis.  It occurs in up to 30% of people with psoriasis, but may also occur in the absence of psoriasis.  In a person with an inflammatory arthritis and psoriasis the diagnosis of psoriatic arthropathy needs to be considered, but is not automatic.

Confirming the diagnosis

There are no specific diagnostic tests and a range of clinical presentations.  Diagnosis typically requires specialist opinion and is normally made on clinical grounds together with appropriate laboratory testing and imaging.  

The appropriate medical specialist is a rheumatologist.

Additional diagnoses covered by SOP
  • psoriatic arthropathy
Conditions excluded from SOP / differential diagnosis
  • Ankylosing spondylitis*
  • Arthritis associated with inflammatory bowel disease#
  • Gout*
  • Osteoarthritis*
  • Reactive arthritis*
  • Rheumatoid arthritis*

* another SOP applies

# non-SOP condition

Clinical onset

The condition presents with pain and stiffness in the affected joints. There is no particular pattern to the joints affected.  A history of psoriasis is present in about 70 percent of patients.

Clinical worsening

The course of the condition is variable but progressive joint damage is likely.  Various treatment options are available that can modify the course of the condition and slow progression.

 
 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/n-p/psoriatic-arthropathy-n059-m070m073/rulebase-psoriatic-arthropathy/inability-obtain-appropriate-clinical-management-psoriatic-arthropathy

Psoriasis

Current RMA Instruments

Reasonable Hypothesis SOP

15 of 2021

Balance of Probabilities SOP

16 of 2021

Changes from previous Instruments


ICD coding
  • ICD-9-CM Codes: 696.0
  • ICD-10-AM Codes: M07.0, M07.3
Brief description

Psoriatic arthritis is a chronic inflammatory arthritis resembling rheumatoid arthritis.  It occurs in up to 30% of people with psoriasis, but may also occur in the absence of psoriasis.  In a person with an inflammatory arthritis and psoriasis the diagnosis of psoriatic arthropathy needs to be considered, but is not automatic.

Confirming the diagnosis

There are no specific diagnostic tests and a range of clinical presentations.  Diagnosis typically requires specialist opinion and is normally made on clinical grounds together with appropriate laboratory testing and imaging.  

The appropriate medical specialist is a rheumatologist.

Additional diagnoses covered by SOP
  • psoriatic arthropathy
Conditions excluded from SOP / differential diagnosis
  • Ankylosing spondylitis*
  • Arthritis associated with inflammatory bowel disease#
  • Gout*
  • Osteoarthritis*
  • Reactive arthritis*
  • Rheumatoid arthritis*

* another SOP applies

# non-SOP condition

Clinical onset

The condition presents with pain and stiffness in the affected joints. There is no particular pattern to the joints affected.  A history of psoriasis is present in about 70 percent of patients.

Clinical worsening

The course of the condition is variable but progressive joint damage is likely.  Various treatment options are available that can modify the course of the condition and slow progression.

 
 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/n-p/psoriatic-arthropathy-n059-m070m073/rulebase-psoriatic-arthropathy/psoriasis