StuWilli, Author at Journal of Urgent Care Medicine

Acute Pericarditis

Urgent message: This case underscores the importance of not “anchoring” to a previous provider’s diagnosis and always remembering that medical conditions are dynamic. JOHN J. KOEHLER, MD, and DANIEL MURAUSKI, DO Introduction Acute pericarditis is defined as inflammation of the pericardium that surrounds the heart and the base of the great vessels. The classical presentation consists of chest pain, a pericardial friction rub, and serial changes on electrocardiogram (EKG). Although data on the incidence of …

Clinical Challenge – May 2014

THE CASE This patient presented with an ankle injury. View the image taken (Figure 1) and consider what your diagnosis would be.

Scribes in the Urgent Care

DAVID WEIN, MD, MBA, FACEP, and DENNIS DIXON, MD For years I was subjected to corporal punishment at the hands of nuns who used to beat me when they could not read my handwriting – at least that is how I remember it. For reasons unknown, my handwriting was never legible. Even back in the day, using the T-System’s “slash and check” charting, my medical records looked like I had either DTs or Benign Essential …

HIPAA for Urgent Care Centers: A Primer

Urgent message: This article discusses potential penalties for violations of HIPAA and key steps urgent care centers should take in order to avoid such penalties. BART WALKER and MEGGAN BUSHEE Complying with the Health Insurance Portability and Accountability Act (HIPAA) can be a daunting challenge for smaller providers. As the urgent care industry grows, its providers will become much more visible targets for scrutiny by the federal government with respect to HIPAA compliance. In addition, …

Evaluation of Headaches in Urgent Care Part 1: Emergent Headaches

Urgent message: Identifying potentially life-threatening or emergent causes of headaches can be challenging in urgent care. Emergent headaches are the focus of the first of a two-part series, aimed at aiding practitioners in appropriate evaluation and management. JACQUALINE DANCY, PA-C, MPAS Introduction The presentation of headaches in the urgent care setting often elicits some healthy angst. Differentiating between potentially life-threatening headaches and more benign varieties can be challenging, especially when the signs and symptoms are …

Risk Mitigation in Urgent Care: Part 2

Lee A. Resnick, MD, FAAFP My previous column presented the building blocks of a risk mitigation framework for your practice. This column specifies high-risk areas of urgent care practice that create exposure for both owner and clinicians and suggests ways to mitigate that risk. Charting / Documentation: Your best defense when there is a bad outcome is documentation. The chart should clearly communicate your decision-making. The “standard of care” is not a guarantee against harm. …

May 2014

X-ray of man with a crush injury to hand

This x-ray was taken on a man with a crush injury to his hand. View the image taken (Figure 1) and consider what your diagnosis would be.

What Percentage of Patients Do Urgent Care Centers Send Elsewhere for Diagnostic Tests?

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).

MDM, E/M Code with Injection Codes

Q. I was approached by a member of the hospital billing department who does urgent care (office based practice) and emergency department billing about a coding question. As the medical director, they asked for my thoughts and support. It’s nice to work at a place that includes the docs! The question revolves around prescription drug management within the management options under the medical decision making (MDM) section pertaining to E/M calculation. We currently do not …