StuWilli, Author at Journal of Urgent Care Medicine

3-year-old boy with a blow to his right elbow

This x-ray was taken on a 3-year-old boy with a blow to his right elbow. View the image taken (Figure 1) and consider what your diagnosis would be.

20-year-old woman with abdominal pain and vomiting

This x-ray was taken on a 20-year-old woman who had presented 4 hours earlier with epigastric pain and a soft abdomen. The symptoms improved with Maalox but she returned because of persistent vomiting. View the image taken (Figure 1) and consider what your diagnosis would be.

Urgent Care Management of Needlestick Injuries: Part 1

Urgent message: Needlestick injuries are common and require a prompt response based on an understanding of the latest USPHS guidelines and informed consent and counseling of the patient. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEP Your center is fortunate to contract with a variety of different business to provide employee health services. A local homeless shelter is one of the clients to whom your center provides new hire physicals, drug screens and …

58-year-old woman with history of bilateral infiltrates

This x-ray was taken on a 58-year-old woman with a history of “recurrent pneumonia” and bilateral infiltrates that did not resolve with antibiotics. View the image taken (Figure 1) and consider what your diagnosis would be.

Developing Data: November, 2013

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). In …

Coding Intravenous Infusions with Hydration; Medical Decision Making

DAVID STERN, MD (Practice Velocity) Q. We perform a lot of IV infusions in our urgent care facility. Sometimes we also perform IV pushes and hydration at the same time as the infusion. We have been billing CPT codes 36000, 96365 -59, 96360 -59, and 96374 -59. Medicare pays for these codes when we append the -59 modifier but I am concerned that this may not be the correct way to bill after reviewing some …

November 2013

Clinical Challenge: November, 2013

Abstracts in Urgent Care: November, 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 survival 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 Administration …

Using Physician Extenders

JOHN SHUFELDT, MD, JD, MBA, FACEP You breathe a deep sigh of relief after learning that you were not the treating provider of a patient who came into your urgent care center and had an unexpected bad outcome. The patient was seen by your mid-level provider who works on opposite days from you in your center. As documented in the medical record, the patient sounds benign: a 28-year-old female who presented with continued sinus symptoms …