Practice Management
A 37-year-old man presents to an urgent care center after 2 days of fever and sore throat. He reports that the soreness is worse with swallowing. He reports that he did not have any preceding rhinorrhea or myalgias. He has had no exposure to ill persons, and he has no history of previous illnesses. He reports that he smokes cigarettes and occasionally drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis …
The Centers for Disease Control and Prevention’s warnings that the 2015–2016 might end up being late, and not just light, are coming to fruition from coast to coast—with deadly consequences for some. New data highlight the need for urgent care providers to continue pushing flu shots and to be prepared for more patients with flu-like symptoms. Current flu activity has been called “widespread” in 37 states, with physician visits for flu-like symptoms continuing to rise; …
Q. How do I use Excludes 1 and Excludes 2 instructions in International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10CM)? A. Put simply, the Excludes 1 notation means that you cannot code any excluded code with the main (listed) code. Conditions listed with Excludes 1 are mutually exclusive. For example, code E11 (type 2 diabetes mellitus) has an Excludes 1 notation with the following codes listed: Diabetes mellitus due to underlying condition (E08.-) Drug …
Eleven children have died from flu or flu-related illness this year, and roughly 20,000 are hospitalized every year in the U.S. thanks to influenza, according to the Centers for Disease Control and Prevention. And yet the C.S. Mott Children’s Hospital National Poll on Children’s Health, 2016 reveals that even 14% of parents who had their children immunized against flu this year believe it is “less important” than other childhood vaccines; perhaps less surprisingly, 59% of …
Digging into the communal nacho platter at a Super Bowl party could give celebrants a bad case of eater’s remorse—in the form of influenza, especially among the hometown fans of the Carolina Panthers and Denver Broncos. It’s no joke: A new study published in the American Journal of Health Economics reports that the death rate attributed to the flu was significantly higher in regions that Super Bowl teams came from between 1974 and 2009. Researchers …
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded visits by patients to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, reveal that for 2014, the top three diagnosis codes at U.S. urgent care centers involved, in descending order: Wounds,15.9% Sinusitis, 11.4% Respiratory conditions, other, 11.2% The bottom three diagnosis codes involved, in descending order: Influenza, 1.6% Tonsillitis, 1.5% Gynecologic issues, 1.5% The survey’s methodology and …
Evaluation and Management There were two revisions and two additions to the “Evaluation and Management” section. Add-on codes 99354, “Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour,” and 99355, “. . . each additional 30 minutes,” were revised to add the term psychotherapy in the description. Some good news in …
If your urgent care center has not seen a boom in patients reporting with flu-like symptoms, don’t assume it’s going to be a slow influenza season. The Centers for Disease Control and Prevention says the annual peak is merely delayed, not lower than expected. In fact, most of the United States is still seeing a gradual climb in reported cases with this year’s peak not expected until at least January. New Jersey and South Carolina …
Local, state, and federal health officials are reminding clinicians and occupational medicine providers to follow safe immunizations practices in the wake of serial missteps during a workplace vaccination program in New Jersey. An article published in the December 18 issue of Morbidity and Mortality Weekly Report notes “disregard for basic vaccine safety” that set in motion a mad scramble to assess and contain any potential danger to 67 workers whom they believe received shots with …
SEAN M. McNEELEY, MD When Accuracy Is a Must, Go for Central Thermometers Key point: Peripheral thermometers are not nearly as accurate as central thermometers. Citation: Niven DJ, Gaudet JE, Laupland KB, et al. Accuracy of peripheral thermometers for estimating temperature: a systematic review and meta-analysis. Ann Intern Med. 2015; 163:768–777. Temperature measurement is performed at most visits to urgent care centers. Although the data are not always important in clinical decision-making, sometimes they are …