Evaluation and Management There were two revisions and two additions to the “Evaluation and Management” section. Add-on codes 99354, “Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour,” and 99355, “. . . each additional 30 minutes,” were revised to add the term psychotherapy in the description. Some good news in …
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Chronic Cough and Shortness of Breath
A 74-year-old man without a significant past medical history presents to an urgent care center reporting 3 days of coughing productive of green sputum, shortness of breath that worsens with exertion, and chills. He says he has a chronic morning cough but states that the sputum has changed color and that his dyspnea has increased. He says he has not had any fever, chest pain, or lower extremity pain or swelling. View the image taken …
Read MoreAbstracts in Urgent Care: February, 2016
SEAN M. McNEELEY, MD Azithromycin Versus Doxycycline for Chlamydia Key point: Azithromycin is a little less effective than doxycycline for chlamydia. Citation: Geisler WM, Uniyal A, Lee JY, et al. Azithromycin versus doxycycline for urogenital Chlamydia trachomatis infection. N Engl J Med. 2015;373:2512–2521. This study of a population in a youth correctional facility compared the effectiveness of azithromycin with doxycycline in the treatment of chlamydia. A total of 567 participants were randomized to regimens of …
Read MoreComplying with Medical Information Restrictions of the Family Medical Leave Act and Americans with Disabilities Act
Urgent message: Urgent care centers that are subject to the Family Medical Leave Act and the Americans with Disabilities Act are limited on the types of questions they can ask related to employee requests for leave. To avoid legal problems, managers should understand the requirements for leave and implement a process for handling information requests. Spencer Hamer, JD Two common laws that employers must deal with regarding employee leave requests are the Family Medical Leave Act (FMLA) and the Americans with Disabilities …
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Shin Pain
Urgent message: Lower extremity injuries are very common in adolescent athletes. Urgent care providers must remember that shin pain is not always simply shin splints. CHRISTOPHER TANGEN, DO, and RYAN SHILIAN, DO Also known as medial tibial stress syndrome, shin splints are described as the painful inflammation of the tibial periosteum, which is generally caused by repetitive physical activity.1 Repetitive injuries can cause incomplete fractures, or microfractures, of the tibia. These tibial stress reactions can predispose the bone to acute fractures. Case Presentation …
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From ZoomCare to ZOOM+: What Can Urgent Care Learn?
Urgent message: ZoomCare, which operates 28 walk-in clinics in the Pacific Northwest, has long been a technological innovator, launching web registration, scheduling, and telemedicine in its markets. In the past year, ZoomCare has evolved further to create ZOOM+, integrating urgent care with insurance, primary care, wellness, specialists, and ancillary services. As ZOOM+ redefines the future of urgent care around the needs of its community, there is much that other urgent care operators can learn in attaining revenue growth from a maturing …
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Urgent Care Management of Geriatric Falls
Urgent message: Falls are a common reason for geriatric patients to present for medical care. In this population, even seemingly minor falls can lead to significant injury, and falls may occur in the first place because of serious underlying medical illnesses. It is critical for the urgent care provider to distinguish which of these patients can be treated in the urgent care setting and which require transfer to a higher level of care. REBEKAH BLICKENDORF, …
Read MoreProvider Credentialing: An 800-Pound Gorilla
Credentialing has become a recurring nightmare for physicians of all specialties, in every state and in every practice setting. Eager for a fresh start, and energized by new opportunity, we decide to make a job change. Recruiters colorfully praise these openings, as if every job pays more than our current one, is closer to parks and culture, and exists in a region with a lower cost of living and, of course, better weather. After a …
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Prosecutors Vigilant to Questionable Medicare Bonuses
A settlement with a billing company in Massachusetts is just the latest outcome of federal prosecutors going after healthcare companies for return of Medicare bonuses claimed in error. It’s a reminder that filing for claims improperly—even if inadvertently—can have serious consequences for operators. In this case, Medical Reimbursement Systems Inc. has agreed to pay $500,000 to settle allegations that it submitted false claims to the military’s Tricare program on behalf of a medical practice in …
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Optum Vows Continued, Dramatic Growth in Urgent Care Acquisitions
UnitedHealth’s OptumCare division already runs over 160 urgent care centers in 14 states by virtue of having bought MedExpress, but it plans to have “several multiples of that number five years from now.” That’s what Optum CEO and UnitedHealth Group vice chair Larry Renfro told a group of analysts recently, citing provider revenues as a key growth factor for the company. Already the largest payer in the U.S., UnitedHealth joins HCA Holdings and Tenet Healthcare …
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