Connecticut Tries (Again) to Regulate Urgent Care Centers

Connecticut Tries (Again) to Regulate Urgent Care Centers

Connecticut lawmakers apparently think “If at first you don’t succeed…” is the perfect approach to slapping licensing fees on the urgent care industry. Democrats in the state House of Representatives have inserted a provision in the current proposed budget that would require all urgent care centers there to carry a distinct license. The problem (for them) is, they don’t have an abiding definition of what constitutes an urgent care center. Currently, the law views urgent …

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Independence Blue Cross Slashes Reimbursements on Modifier 25

Independence Blue Cross Slashes Reimbursements on Modifier 25

Independence Blue Cross has implemented a new policy that cuts reimbursements on procedures billed with modifier 25 (“Significant, separately identifiable E/M service”) by half for care given to Medicare Advantage members and patients covered by private insurance plans. The lower rate does not apply to traditional Medicare claims. Independence covers patients under its own name, but also through QCC Insurance Company, Keystone Health Plan Eastand AmeriHealth. The move sets Independence apart from other payers, including …

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A 30-Year-Old Woman with a ‘Burning’ Tongue

Case A 30-year-old woman visited urgent care complaining of a burning sensation on her tongue. At first, she had blamed it on a spicy meal, but the feeling didn’t go away and now she feels as though she isn’t able to taste food as usual. Looking back, she recalls that over a month ago she noticed a white plaque on her tongue. However, that had had disappeared within a day so she hadn’t thought much …

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A 73-Year-Old Man with a 2-Week History of Palpitations

A 73-Year-Old Man with a 2-Week History of Palpitations

Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …

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A 21-Year-Old Male with Foot Pain

A 21-Year-Old Male with Foot Pain

Case A 21-year-old male presents with pain after dropping a piece of furniture on his right foot. He is physically able to bear weight during the assessment, though his pain is evident and he is unsteady when shifting his weight to the injured foot. 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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Come October, Come the Flu

On paper, flu season starts next month, meaning it’s an ideal time to start reminding patients they’ll need flu shots (and that you’ll be happy to provide one). While the majority of children tend to get their shots toward the end of the season according to the Centers for Disease Control and Prevention, the distribution has been more evenly distributed for adults over the past few flu seasons, as seen in Figure 1, below. The …

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Urgent Care Evaluation for Snakebite Envenomation

Urgent Care Evaluation for Snakebite Envenomation

Urgent message: Snakebite envenomation is relatively rare, but immediate action upon presentation to the urgent care center—including quick and accurate identification, appropriate care, and sound decisions regarding transfer to the ED—maximize the chance for optimal outcomes. Andrew Vang, DO Introduction Snake venom poisoning is a complex medical emergency that is seen infrequently, but when encountered requires rapid recognition and urgent management. The following discussion will focus on appropriately identifying snakebites from indigenous venomous species in …

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2018 ICD-10-CM: A Preview of Urgent Care-Relevant Changes

2018 ICD-10-CM: A Preview of Urgent Care-Relevant Changes

It’s again time to review what has changed with the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) effective October 1, 2017 through September 30, 2018. There are 360 new, 142 deleted, and 226 revised diagnosis codes in the final update. We will review the changes most relevant to urgent care, but the examples shown here are not all-inclusive. You can find all updates in the Centers for Medicare and Medicaid Services (CMS) website …

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Quality Improvement Report: Improving Telephone Follow-Up in an Urgent Care Setting

Quality Improvement Report: Improving Telephone Follow-Up in an Urgent Care Setting

Urgent message: Follow-up after a patient visit is essential to the continuum of care and to the perception of customer service. Especially in the urgent care setting, where providers may have no ongoing relationship with a patient, the most basic office practices (eg, collecting accurate and accessible contact information) can seem deceptively simple but are of critical importance. Jimmie Toler, MSN, NP-C, Emily E. Johnson, PhD, and Barbara J. Edlund, PhD, ANP, BC Introduction Continuum …

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