The Centers for Medicare and Medicaid Services announce an update to claim adjudication rules for National Correct Coding Initiative Procedure-to-Procedure edits to allow bypass of an edit if modifiers 59, XE, XS, XP, or SU are appended to either the column one or column two code. In 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the following modifiers, referred to as X{EPSU} and intended to provide more information in scenarios where modifier -59, …
Read More
An 18-Year-Old Female with Sudden Sharp Chest Pain
Figure 1. Case The patient is an 18-year-old female who presents to urgent care with 1–2 hours of “sharp” chest pain that worsens with range of motion. She reports it began suddenly while lifting boxes at work. Pain is not improved with acetaminophen. She denies exertional discomfort, pleuritic pain, and use of hormone therapy. There is no leg swelling, shortness of breath, or sweating. Physical exam reveals: General: Sitting comfortably on the cart, breathing …
Read MoreNew Data Show Urgent Care Outpacing Retail and ED Traffic
Urgent care started as something akin to the California Gold Rush; if a physician had the resources, the inclination, and the chutzpah to do so, they could stake a claim in the great wilderness of this new way of practicing medicine. The more reticent (some would have said prudent at the time) stayed in their lanes to continue practicing traditional family medicine, or pediatrics, or take shifts in the emergency room. Competition was scarce. That …
Read More
An 11-Year-Old Girl with Back Pain and Chronic Poor Appetite
Urgent message: Patients with recurrent symptoms should have an expanded history—including a genitourinary history in premenarchal girls. Lavanya Boddu, MD, MBA PRESENTATION The patient is an 11-year-old female brought by her mother to urgent care, with a chief complaint of back pain. The patient was pushed down at school about 2 weeks ago playing ball, landed on her buttocks, and is complaining of back pain radiating to BL hips. She is still able to walk …
Read More
Top 5 Common Causes—and Controversial Conducts—of Heel Pain in Urgent Care
Urgent message: Nontraumatic heel pain is a common presenting complaint in urgent care. Knowing how to accurately diagnose and develop a treatment plan is important, as the course is typically prolonged. Katty Grand-Pierre, MD, CMSS, Frank Ida, BS, EMT-B, and Vincent D’Amore, MD, FACEP INTRODUCTION The heel can absorb 110% of body weight while a person is walking and 200% of body weight during running.1 While the most common cause is plantar fasciitis (PF), accounting …
Read More
Blue Cross Blue Shield Plans Look to Extend Reach into Primary Care and Urgent Care
Working with healthcare giant Sanitas USA, Blue Cross Blue Shield (BC/BS) plans in numerous states are opening up primary care clinics that further complicate the competitive landscape occupied by urgent care, retail clinics, hospital systems, and traditional medical practices. The partnership already operates such practices in several markets in Florida and New Jersey, both of which may be expanding. Next on the horizon are plans to work with Health Care Services Corp., which owns BC/BS …
Read More
Online Reviews Matter—a Lot—to Patients, and They Expect You to Listen
Some operators may dismiss online reviews as a random mishmash of disgruntled patients spewing sour grapes when a doctor visit didn’t go the way they wanted or, to the other extreme, meaningless praise heaped on a business by shills. Those operators do so at their own peril, however, as a new survey reveals that online reviews matter a great deal to patients who are about to make healthcare decisions. According to the report from PatientPop, …
Read More
Be Alert for Hep A Cases, Especially in Certain States
The ongoing (and building) measles outbreak is getting most of the headlines, but simultaneous to that hepatitis A cases have continued to mount well into the thousands. Since the first confirmed case in 2016, more than 15,000 infections have occurred across the country; some 8,500 have required hospitalization. Florida has been hit especially hard, with 883 cases reported so far this year. That’s more than the total for all of 2017 and 2018 combined. Virginia …
Read More
DOs Ascending—How the Growth of Osteopathy Might Save Urgent Care from the Looming Physician Shortage
Urgent message: As the ever-growing physician shortage continues to strain the long-term viability of the nation’s healthcare system, urgent care would be well-served to cultivate relationships with osteopathic medicine schools toward tapping a potentially fertile yet underutilized clinical resource. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. The United States healthcare system continues to face a serious and …
Read More
Current Drug Test Data Reflect New Trends in Opioid and Marijuana Use Among Workers
As marijuana use becomes legal in more communities across the country and urgent care providers (among others) get the message that opioid prescriptions have been far too prevalent, the nature of positive drug tests in the U.S. workforce seems to be changing with the times. Based on more than 10 million workplace drug test results in 2018, Quest Diagnostics reports growth in positive results for marijuana, while positive results for most opiates were down vs …
Read More