DAVID STERN, MD (Practice Velocity) Q.Which CPT codes can be used for diagnosis codes 786.50 (unspecified chest pain) and 414.9 (chronicischemic heart disease-unspecified) to maximize a Medicare patient bill? A.The basic rule of coding is that you should code for the services rendered, not to “maximize a patient bill.” In other words, you should code the best codes that indicate the actual services that were performed. For these codes, you could code for a cardiac …
Read MoreAbstracts in Urgent Care: October, 2011
A New Approach to Managing Young Non-Toxic-Appearing Febrile Children Keypoint: Researchers suggest an emphasis on more limited evaluation, now that vaccines have greatly reduced the likelihood of serious bacterial infections. Citation: Jhaveri R, Byington CL, Klein JO, Shapiro ED. Management of the non-toxic-appearing acute lyfebrile child: a 21stcentury approach. J Pediatr. 2011;59(2):159:181. Since the 1970s, considerable attention has been paid to the management of febrile children aged £3 years without an obvious focus of infection. …
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October 2011
Developing Data: October, 2011
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 centers,” the qualifications for which included accepting walk-ins during all hours of operation, as well as having a licensed provider on site, x-ray and labs on site, the ability to administer IV fluids and perform minor procedures, and being open seven days a week, …
Read MoreClinical Challenge: October, 2011
The patient, an otherwise-healthy 42-year-old, presented with bilateral back pain around the pelvis. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
Read MoreSelling Your Urgent Care? Here’s What’s Involved
JOHN SHUFELDT, MD, JD, MBA, FACEP A large urgent care group has just offered to buy your centers. So now what? First, get some advice. This process is incredibly time-consuming inasmuch as the amount of material and the degree of detailed information required before a sale is consummated is daunting. Also, the way you position and promote your center and the thoroughness of your disclosures will speak volumes about your abilities and will ultimately be …
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Take Patient Satisfaction to the Next Level
Urgent message: Companies like Apple and Nordstrom have raised the quality of customer experience to an art form, one that urgent cares would do well to emulate. ALAN A. AYERS, MBA, MACC, Experity Introduction Urgent care is positioned as a consumer-focused delivery channel for low-acuity medical services differentiated from hospital emergency departments and primary care practices by retail-facing locations, extended evening and weekend hours, and walk-in convenience. As with airlines, restaurants, and other service businesses, …
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A Surprising Cause for “Pregnancy”
Urgent message: When a test does not confirm a patient’s theory about the cause of her symptoms, both patient and provider must look elsewhere. SEAN MCNEELEY, MD Introduction When a mother of three complains of symptoms of pregnancy, the test usually confirms that she is right. Occasionally, however, the results are surprising, as this case illustrates. Case Presentation WM, a 28-year-old female, presented to an urgent care with concerns that she might be pregnant and …
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The Case of a 32-year-old Woman With Headache
When an Uncommon—Potentially Catastrophic—Diagnosis Is Masked by a Common Complaint In Bouncebacks, which appears quarterly in JUCM, we provide documentation of an actual patient encounter, discuss patient safety and risk management principles, and then reveal the patient’s “bounceback” diagnosis. This Bouncebacks case is unique in that it also went to trial, excerpts from which are also presented. This case is adapted from the Bouncebacks! Medical and Legal (Anadem Publishing) by Michael B. Weinstock, MD, and …
Read MorePediatric Foreign Bodies
Urgent message: A variety of objects find their way into the ears, noses, and throats of children. Some can be lethal and require ED or specialist referral. Others can be safely removed in an urgent care setting. ANN MARY BACEVICE, MD In children who are brought to an urgent care for treatment, foreign bodies are common. Especially if they are between the ages of 18 months and four years, children will insert objects into their …
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