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Arthritis and xrays

SPO

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SPO Rising Star

SPO

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I had a C&P on the 7th and today I was told I need to go get x-rays done.  I'm going to assume this is because the doc returned my exam with a positive arthritis diagnosis.  This arthritis seems to usually be rated analogous to rheumatoid and the  early stages often don't show in x-rays.  Are X-rays mandatory for all arthritis claims of any type?  QTC quality department said they are required to request x-rays on arthritis, but I don't know if they are differentiating types. Is there anything I can do to remind them that their manual even says Rheumatoid (and I would assume analogous condition) may not show on X-rays?  I am concerned based off some VBA decisions I've read that they jump to conclusions and deny if the X-rays come back normal. 

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kanewnut Proficient

kanewnut

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I really don't know the answer to your question. I have been diagnosed with arthritis, but not rheumatoid. Mine is degenerative. I have asked about X-rays at past C&P's and was told that once diagnosed with arthritis there was no more need for X-rays. Maybe someone else will be able to add some more to your question.

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broncovet Grand Master

broncovet

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Arthritis does not necessarily have to show up on x rays to be compensable.  See this:

https://www.law.cornell.edu/cfr/text/38/4.71a

However, there has to be evidence of same if it does not show up on xray's.  Read the regulation for further explanation.  

 

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SPO Rising Star

SPO

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I saw that something in(M-21) analogous to Rheumatoid (diagnostic code 5002) wouldn't have to show up on X-rays,  I'm just wondering if all the raters understand this and don't just assume the its should be treated like osteo or degenerative.  I guess they will take x-rays (not like I can say no) and  hope they use x-rays findings to increase the rating if anything shows, not to deny if it doesn't.  (Obviously I trust the VA about as far I can throw them)

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kanewnut Proficient

kanewnut

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13 hours ago, SPO said:

I'm just wondering if all the raters understand this

I sometimes doubt very seriously that the raters understand much at all.

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