Q. How does one determine whether an E/M code can qualify for coding according to time spent? Obviously, any psychiatric counseling would fit the criteria, but what about “teaching” (e.g. how to use an inhaler, how to perform a breast exam), or preventive medicine counseling? – Question submitted by Dr. Kim, Med7 Urgent Care, CA A. The key issues on counting counseling or coordination of care toward the E/M code are: Counseling and/or coordination of …
Read MoreDeconstructing the Ten Commandments of Urgent Care Medicine
Since the holiday season was just upon us, I will take the opportunity to borrow heavily from the 1956 Cecil B. DeMille movie, The Ten Commandments. The movie portrays the life of Moses, from an infant floating down the Nile through his return to Egypt to lead the Hebrews across the Red Sea. For the next few paragraphs, think of me as the Moses of Urgent CareWorld, as I attempt to lead you to the …
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Building Urgent Care Referral Relationships: Pharmacies and Retail Host Clinics
Urgent message: Viewing other community healthcare providers (e.g., pharmacists) or even possible competitors (e.g., retail clinics) as referral sources can increase revenues and bolster the urgent care center’s place in the healthcare system. The first of two parts. Alan A. Ayers, MBA, MAcc Urgent Care has evolved to the point that it is a vital part of a community’s healthcare infrastructure, offering access when primary care appointments are unavailable and relief when emergency rooms are …
Read MoreAbstracts in Urgent Care: January, 2010
CAP Treatment Recommendations: Guided in the Right Direction Key point: Results of two large cohort studies indicate that adherence to guidelines for treating community-acquired pneumonia is a good thing. Citations: Arnold FW, LaJoie S, Brock GN, et al. Improving outcomes in elderly patients with community-acquired pneumonia by adhering to national guidelines: Community-Acquired Pneumonia Organization International Cohort Study results. Arch InternMed. 2009;169:1515-1524. McCabe C, Kirchner C, Zhang H, et al. Guideline-concordant therapy and reduced mortality and …
Read MoreClinical Challenge: January, 2010
The patient is a 16-year-old male who presents with difficulty breathing and pain in his throat, along with difficulty swallowing and pleuritic chest pain. All the symptoms began “a couple of hours” prior to presentation. There is no history of trauma or choking, nor of a recent dental procedure. On exam, the patient looks well, and is quiet and not toxic; there are no sign of distress. Pulse is 75, O2sat 94 and there is …
Read MoreReducing Pediatric Medical Legal Risk in Your Urgent Care Center
Assessment, Intervention, and Disposition of Patients with Psychiatric Symptoms
Urgent message: Assessment of patients presenting with psychiatric conditions requires amodified set of skills compared with traditional medical assessment. Urgent care clinicians must be prepared to determine appropriate interventions—treatment, referral, or both. Gregory P. Brown, MD Introduction Typically, the interaction between clinicians and patients presenting with psychiatric conditions is guided by information obtained from the interview, history, and physical examination rather than emphasizing laboratory or radiological testing. Therapeutic options may be challenged by a lack …
Read MoreIn Support of a Pledge
If you are reading this, you should be a member of UCA. No cheating…keep reading. The Urgent Care Association (UCA) is your representative organization. Whether you are a practice administrator, biller, owner, physician, physician assistant, or nurse practitioner, UCA is doing the heavy lifting on your behalf to build the foundation of this industry and discipline. Consider the following: UCA was founded six years ago with the vision to be the catalyst for the recognition …
Read MoreJanuary 2010
Insights In Images
The patient is a 2 ½-year-old child whose parents report recurrent episodes of abdominal pain without vomiting or diarrhea. On exam, you note fullness of the abdomen. 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.
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