Two-Thirds
JOHN SHUFELDT, MD, JD, MBA, FACEP Editor’s note: For almost 10 years, Dr. John Shufeldt has generously shared his talents as a writer, legal expert, and thought leader with JUCM readers as the contributing editor of our Health Law department. Although John is retiring as its regular contributor, he will always remain its award-winning founder. In future issues, the Health Law column will be expanded to include new contributors and cover a broader scope of …
Read MoreIntravenous Therapy
Q. We perform a lot of intravenous (IV) infusions in our urgent care facility. Sometimes we also perform IV pushes and hydration at the same time as the infusion. What is the correct way to code multiple IV infusions? Do we have to document start and stop times for each IV service? A. If an IV infusion and IV push are performed concurrently in the same IV site, you should only bill one “initial” code. …
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Pediatric Periorbital Cellulitis from an Intranasal Button Battery
Urgent message: When a child presents with periorbital cellulitis with no obvious cause, checking for intranasal foreign body, such as a button battery, is of paramount importance. Serious complications can be avoided if the foreign body is removed in a timely manner. MAY MOHTY, MD, FAAP, FAAUCM, and JACOB ANDERSON, DO Preseptal cellulitis, also known as periorbital cellulitis, is a relatively common diagnosis in the pediatric population. It is defined as infection of the space …
Read MoreClinical Challenge: June, 2015
The Case The patient presented with painless hard masses on one lower leg. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreTop Types of Diagnosis Codes at U.S. Urgent Care Centers in 2014
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that the top types of diagnosis codes for visits included respiratory (52.9%), wound/trauma/fracture (34.9%), ear (9.2%), dermatologic (7.5%), and genitourinary (7.0%). The survey’s methodology and data abstraction forms were initially designed in 2008 by researcher Robin M. Weinick, PhD, then an assistant professor at Harvard …
Read MoreShoulder Pain in the Urgent Care
Urgent message: Shoulder pain is not always “just another musculoskeletal complaint.” It may be referred pain indicating life-threatening conditions. Many patients use urgent care centers as sources of primary care. Thus when we make an important diagnosis because of our methodical, stepwise approach to examination, we have the opportunity to be the providers who ultimately expedite diagnosis and care for these patients. MIZUHO SPANGLER, DO, and MICHAEL B. WEINSTOCK, MD Shoulder pain is the third …
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The Role of Urgent Care in an Integrated Care System: Insights from Intermountain Healthcare
Urgent message: This exclusive interview with Intermountain Medical Group Chief Executive Officer Linda Leckman, MD, illustrates how urgent care can improve access and clinical outcomes while reducing costs for patients in a system that integrates providers, hospitals, and health insurance using a shared electronic medical record and capitated payment. ALAN A. AYERS, MBA, MAcc, Experity Introduction In the evolving U.S. health-care system, individual providers, ancillary facilities, hospitals, and payors are joining together in connected systems …
Read MoreAbstracts in Urgent Care: June, 2015
SEAN M. McNEELEY, MD Sudden Death When Older Patients Taking Spironolactone Are Given Trimethoprim-Sulfamethoxazole Key point: Another drug interaction with potential deadly consequences. Citation: Antoniou T, Hollands S, Macdonald EM, et al; Canadian Drug Safety and Effectiveness Research Network. Trimethoprim-sulfamethoxazole and risk of sudden death among patients taking spironolactone. CMAJ. 2015;187:E138–143. It is known that the combination of trimethoprim-sulfamethoxazole (TMP-SMX) and spironolactone may increase potassium levels in patients. This study is very similar to one …
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Pharmacists With Prescribing Privileges: A New Class of Medical Practitioner
Alan A. Ayers, MBA, MAcc, is Practice Management Editor for JUCM, serves on the board of directors of the Urgent Care Association of America, and is Vice-President of Strategic Initiatives for Experity. Urgent message: State boards of pharmacy, the National Association of Boards of Pharmacy, and large national drugstore chains are pushing for regulatory changes that would enable pharmacists to diagnose medical conditions and prescribe a range of medications, creating a new class of health-care …
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