StuWilli, Author at Journal of Urgent Care Medicine

Clinical Challenge: July/August, 2014

THE CASE This patient presented with a sprained knee. View the image taken (Figure 1) and consider what your diagnosis would be.

Abstracts in Urgent Care: July/August, 2014

Clinical prediction rule for ureteral stones Key point: A new clinical score may predict the presence of uncomplicated ureteral stones and reduce the need for CT scan. Citation: Moore CL, Bomann S, Daniels B, et al. Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone—the STONE score: Retrospective and prospective observational cohort studies. BMJ. 2014; 348:g2191. In this two-phase trial, five factors were identified and then prospectively validated for prediction of ureteral …

Acute Rheumatic Fever

Urgent message: Patients with seemingly unusual conditions do present to urgent care, underscoring the need to always take a thorough history for all “red flag” symptoms. LEE A. RESNICK, MD, FAAFP Introduction While the incidence of acute rheumatic fever has declined significantly in developed countries over the last several decades, sporadic cases do still occur. Diagnosis may be difficult due to the non-specific symptoms and the lack of experience with the condition amongst most urgent …

Expert Perspectives on Telemedicine in Urgent Care

Urgent message: Telemedicine—or “at-home” medicine—affords unique business opportunities to urgent care providers who can overcome barriers to adoption such as reimbursement. Introduction Telemedicine is a topic that frequently comes up among UCA’s membership as an area of interest. Some urgent care providers view telemedicine, or “at-home” medicine, as an opportunity; others see a threat. A lot of questions exist about telemedicine and with this roundtable, we’ve pulled together the unique experience of individuals who are …

Evaluation of Headaches in Urgent Care Part 2: Non-Emergent Headaches

Urgent message: Headaches are challenging chief complaints and being able to identify and differentiate among the non-emergent types of headaches will help with medical decision making and patient care. JACQUALINE DANCY, PA-C, MPAS In the conclusion of a two-part series, this article focuses on non-emergent headaches. For the purpose of this article, non-emergent headaches are classified as those that are not life-threatening and pose little to no risk of permanent functional disability. Most non-emergent headaches …

July/August 2014

What Are the ICD-9 Codes Most Used by Urgent Care Centers?

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care).

New vs. Established Patients, Medicare Exam, ICD-10 Delay

Q. A patient with Medicare as his primary insurance needs a physical and EKG for clearance for an MRI with sedation ordered by his neurologist. Symptoms are imbalance along with pain in the shoulder, neck, and upper spine. Can I use the pre-op code V72.81 because there is sedation even though there is no actual surgery? Or should I just get a signed Advanced Beneficiary Notice (ABN) and expect a denial? A. Yes, you can …

Abstracts in Urgent Care: June, 2014

Modification of Wells criteria in cancer, previous DVT Key point: Wells criteria for deep venous thrombosis (DVT) may need modification for patients with cancer or previous DVT. Citation: Geersing GJ, Zuithoff NP, Kearon C, et al. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data metaanalysis. BMJ. 2014;348:g1340. Possible DVT is an important diagnosis to make, however, many urgent cares do not have access to ultrasound. A combination …

Clinical Challenge – June 2014

THE CASE These x-rays were taken on a 49-year-old man with chronic bilateral knee pain that had increased over the past 6 months with ambulation. Examination was unremarkable. View the images taken (Figures 1, 2, and 3) and consider what your diagnosis would be.