DAVID STERN, MD (Practice Velocity) Q.I was curious about your response to a case listed in Coding Q&A in the November issue of JUCM. The case described a patient who returned for reopening of a wound due to infection. The physician then cleansed and re-sutured the wound. Although I agree about the postoperative care in general, I wonder if modifier -79 would be appropriate in these circumstances. According to instructions by the AMA, this modifier …
Read MoreAbstracts In Urgent Care: December, 2007
A 14-year-old who took a fall two hours prior to presenting to the urgent care clinic
The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise healthy. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreCustomer (and Patient) Service is Key in Occupational Health
“Let sales people sell” should be more than a cliché; it should be a way of life. Unfortunately, though, many occupational health sales professionals spend a disproportionate amount of time engaged in client maintenance and customer service at the expense of direct sales. This is not to say that customer service and patient service are unimportant, however; in truth, maintaining good relationships both with customers and patients is crucial to the success of every occupational …
Read MoreCompliant Management of Non-Compliant Staff
JOHN SHUFELDT, MD, JD, MBA, FACEP Are you from the era where Spare the Rod, Spoil the Employee was the title of the disciplinary section in the employee manual? Most urgent care centers in the United States discontinued the practice of caning employees after Michael Fay received his licks for vandalizing cars in Singapore in 1994. Now-a-days, you may want to consider following a few simple rules when it comes to employee remediation (as opposed …
Read MoreA Box of Chocolates
What, you may be asking, does urgent care have to do with chocolate? One thing we all know, whether you are running an association or unlocking your urgent care center doors every morning, is that as each day dawns (in the wise words of Forrest Gump), you never know what you are going to get. Will this be a record-setting patient visit day or an inexplicable lull? Will a couple hundred people show up for …
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November 2007
Developing Data: November, 2007
As an emerging distinct practice environment, urgent care is in the early stages of building a data set specific to its norms and practices. In Developing Data, JUCM will offer results not only from UCA’s annual benchmarking surveys, but also from research conducted elsewhere to present an expansive view of the healthcare marketplace in which urgent care seeks to strengthen its presence. In this issue: The 2007 Professional Research Consultants National Consumer Survey asked patients …
Read MoreAddressing Problem-based Coding and Other Challenges
Q.We are a fairly new urgent care center and could use some help on E/M coding. I have read on various urgent care websites that we can bill each visit as a new patient visit (as long as it isn’t a follow-up to an existing problem). Can you please give me some direction on where I can find this information? A.What you are referring to is “problem-based coding.” Never code in this way unless you …
Read MoreAbstracts In Urgent Care: November, 2007
Effectiveness of Oxycodone, Ibuprofen, or the Combination in the Initial Management of Orthopedic Injury-Related Pain in Children Key point: Oxycodone, ibuprofen, and the combination all provide effective and similar analgesia for mild-to-moderate orthopedic injuries in children. Ibuprofen, alone, is a legitimate and effective choice. Citation: Koller DM, Myers AB, Lorenz D, et al. Pediatr Emerg Care. 2007;23(9):627-633. Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have …
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