Symptoms May Say Sinusitis, But Scans Disagree Key point: Infection and even inflammation were not reliably present in the scans of patients with classic sinusitis symptoms. Citation: Ferguson BJ, Narita M, Yu VL, et al. Prospective observational study of chronic rhinosinusitis: Environment triggers and antibiotic implications. Clin Infect Dis. 2010; 54(1): 62-68. (http://dx.doi.org/10.1093/cid/cir747) Chronic sinusitis can be difficult to diagnose precisely and sometimes even more difficult to treat. Increasingly, experts are suggesting that antibiotics may …
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March 2012
Clinical Challenge: February, 2012
The patient, a 66-year-old male, presented with a twisted right foot, with lateral tenderness. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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February 2012
Oral and Facial Injuries in Urgent Care
Urgent message: For patients, cosmesis is often the top priority. But for clinicians, ruling out serious or life-threatening injury is paramount. Sean McNeeley, MD Introduction Patients with oral and related facial injuries often present to urgent care providers. Consider JT. He is 25-year-old male who was taken to an urgent care clinic by his friends after falling while mountain biking near his Ohio home. His friends were concerned because the hill was steep, and although …
Read MoreDeveloping Data: February, 2012
These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care center” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. In this …
Read MoreAdministration Codes for Injections, Billing for Medicare Wellness Exam, Billing Joint Injections With E/Ms, Coding for Keloid Injection
DAVID STERN, MD (Practice Velocity) Q. What is the appropriate administration code for a Medicare patient who receives influenza, Pneumovax, and tetanus vaccinations? What are the proper administration codes for the same patient if he/she receives a tetanus and flu shot? Name Withheld A. For Medicare: Influenza vaccine administration is G0008 Pneumovax administration is G0009 Tetanus vaccine administration is 90471 Q. If you perform an annual Medicare wellness exam, can you bill for additional services …
Read MoreAbstracts in Urgent Care: February, 2012
Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Gloves Are No Substitute for Proper Hand Hygiene Key point: Healthcare workers frequently neglect hand hygiene when they use gloves. Citation: Fuller C, Savage J, Besser S, et al. “The dirty hand in the latex glove”: a study of hand hygiene compliance when gloves …
Read More‘First, Do No Harm’ But Don’t Be a Harmful Do-Nothing!
As scientists, we are trained to question through research – to pose hypotheses and test for proof. Science, however, is notoriously flawed and imperfect, and has left a trail of discarded practice standards refuted through additional study or missed statistical error. Many a medical proverb has fallen out of favor this way – but none has withstood the test of time longer than “First, do no harm.” With an almost religious favor, physicians have embraced …
Read MoreClinical Challenge: February, 2012
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected] The patient, an otherwise healthy 70-year-old, presented with a fever and cough on the right side of the chest. View the image taken (Figure 1) and consider …
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