StuWilli, Author at Journal of Urgent Care Medicine

Coding for Intravenous Infusion, Fees for S9083, Morgan Lens Irrigation, and UB-04 Revenue Codes for Urgent Care

DAVID STERN, MD (Practice Velocity) Q.I had a patient come in who needed IV fluids and monitoring for five hours. We found the CPT codes 96360 (intravenous infusion, hydration; initial 31 minutes to 1 hour) and 96361 (each additional hour…) to use for the IV hydration therapy. However, my doctor cannot believe how low these codes are reimbursed by his health insurance. We did bill an office visit in addition to the IV. Is this …

Clinical Challenge: February, 2011

The patient is a 10-year-old who presents after experiencing a blow to the right elbow, with resultant pain on extension of the arm. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Hearing the Hoof Beats of Zebras! Facial Nerve Palsy: A Case Report

Urgent message: There is no diagnosis so “common” that it cannot be missed or mistaken for something else. A systematic approach to the history and examination are crucial to reaching the right conclusion and positive outcomes. Lee A. Resnick, MD Every now and then, medical school pearls are wrong. You remember: “When hearing hoof beats in Central Park, don’t go looking for zebras.” It may be true that zebras are infrequent visitors to New York …

Pitfalls in Assessing and Managing Common Pediatric Injuries

Urgent message: Fractures are common among pediatric patients. Familiarity with the growth process and the unique properties of the immature skeleton—as well as immediate identification of conditions requiring emergent referral—are necessary for appropriate care and avoidance of long-term sequelae. The first of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD Injuries that ultimately prove to be fractures are a common cause of visits to the emergency room and urgent care among …

A Crisis in Quality? Lessons from History

Lee A. Resnick, MD, FAAFP If history repeats itself, then we just may be in big trouble. Many of us remember the doc-in-the-box days of the early 80s, when the first urgent care boom occurred. There was a wild proliferation of urgent care centers, driven mostly by physician entrepreneurs looking to make a quick buck. By 1985, in excess of 3,000 centers dotted the country. The following decade brought significant contraction within the industry, before …

42-year-old woman in considerable ankle pain

The patient is a 42-year-old who presents to urgent care after “twisting” her left foot. She is able to bear weight on the foot, though not without evident considerable pain. View the image taken and consider what your diagnosis and next steps would be.

Assessing for Life-threatening Chest Pain in the Urgent Care Center

Urgent message: Data show that urgent care centers are becoming a more common destination for patients experiencing chest pain. Immediate recognition of emergent vs. urgent causes may be the make-or-break moment for the patient’s outcome. Jasmeet Singh Bhogal, MD Introduction Evaluation of chest pain always presents as a diagnostic challenge, be it in the outpatient family medicine setting or the hospital emergency department. In fact, urgent care centers occupy a unique position in the equation; …

Developing Data: January, 2011

In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we begin delving into a report whose top-line data made headlines around the country recently. The article, Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics,1 went beyond the conclusion stated in its title, offering a snapshot of how patients exercise their freedom to choose among those three settings. …

Getting Paid: Ten Steps to Reducing Accounts Receivable

Urgent message: Unlike businesses that expect—and receive—full payment at the time services or goods are secured, urgent care centers often wait for full payment from third-party payors. Efficient management of accounts receivable is crucial to the center’s financial viability. By Alan A. Ayers, MBA, MAcc Practice Velocity Urgent care centers—which appeal to consumers on the basis of high-visibility locations, extended hours, and walk-in convenience—are often compared to “retail” businesses. Unlike stores, restaurants, and other “retailers” …