StuWilli, Author at Journal of Urgent Care Medicine

2014 CPT Changes, Suture Removal, Place of Service Code

DAVID STERN, MD (Practice Velocity) Q. I understand that we will be able to bill for cerumen removal for both ears in 2014. Is that true? A.Yes. In 2014, you will be able to bill CPT code 69210, “Removal impacted cerumen requiring instrumentation, unilateral” with modifier -50, “Bilateral procedure.” Keep in mind, Medicare will typically not cover simple, non-impacted earwax removal. CMS requires that physicians meet the following criteria for reimbursement of the removal of …

Clinical Challenge: December, 2013

The patient, a 12-year-old female, presented after twisting her right ankle. She could not bear weight on her right leg. View the image taken (Figure 1) and consider what your diagnosis would be.

Abstracts in Urgent Care: December, 2013

Long-term survival following pneumococcal pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term sur- vival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans …

Help me understand…

JOHN SHUFELDT, MD, JD, MBA, FACEP lease don’t share this with anyone but truth be told, I love paramedics. I sometimes thought I had it bad (I really didn’t think that, but it makes the story better if I sound tragic) treating the myriad disenfranchised in an inner city ED until I talked with the paramedic who wrestled the feces-covered, bath salts and meth-using, naked, combative maniac who was my patient the previous night. (The …

Erythema Infectiosum

Urgent message: Rashes are common in urgent care and taking a careful patient history is important for proper diagnosis of the underlying cause. ICHHA SETHI, MB,BS, JASKARAN S. SETHI, MB,BS, MIKAYLA SPANGLER, Pharm D, BCPS, and SHAILENDRA SAXENA, MD, PhD Introduction Physicians in both primary care and urgent care clinics encounter facial rash quite frequently. Given the high prevalence and variable number of etiologies, it is important to diagnose these patients appropriately so that they …

December 2013

Improving Urgent Care Center Profitability Through Medical Supply Management and Accounting

Urgent message: Many urgent care centers lack an inventory management process and do not accurately account for their utilization of supplies. Improving how a center manages and accounts for supplies can have a direct impact on the bottom line. ALAN A. AYERS, MBA, MAcc Practice Velocity Introduction A quick and easy way to improve your urgent care center’s profitability may be as close as your supply closet. Many urgent care centers lack defined processes for …

Urgent Care Management of Needlestick Injuries: Part 2

Urgent message: Response to a needlestick with potential for HIV exposure requires understanding of both state laws on HIV testing and the latest USPSTF guidelines for post-exposure management. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEPTwo police officers arrive at your urgent care site with a handcuffed, bloodied prisoner. One officer tells you that the person in custody “spit on me” during the altercation. The officer goes on to tell you that the …

The Urgent Care Foundation: Building a Stronger Specialty

Lee A. Resnick, MD, FAAFP The discipline of urgent care medicine remains in its developmental infancy. While the strong consumer-driven market lurching toward efficient and cost-effective health care delivery systems has supported astounding industry growth, our discipline continues to struggle to define itself. Like all new specialties, urgent care medicine has, in fits and starts, made efforts to evolve an identity, but despite early gains, it’s been an up and down effort. Most every urgent …