Max Lebow, MD, MPH, FACEP, FACPM Urgent message: A thorough, occupational medicine-specific history is essential to identifying and resolving work-related injuries and illnesses quickly and safely—for the benefit of the patient and the employer. Like any medical history, the occupational medicine history is meant to guide the clinician to the proper diagnosis and treatment for the patient. However, it is set apart from the “typical” history in that several other goals must be …
Read More2019 International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) Codes
October 1, 2018 will bring 279 new codes to ICD-10-CM. Combined with 51 deactivated codes (and 143 revised codes), that brings the total number of ICD-10-CM codes to 71,932. We identified a few examples that are especially important for urgent care coders to be aware of; a complete list of ICD-10-CM changes can be found on the CMS website at https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html. Chapter 2: Neoplasms (C00-D49) Melanoma and other malignant neoplasms of the skin The …
Read MoreWarning: The Future of Patient Engagement May Require Straying Beyond Your Comfort Zone
Urgent care has faced many challenges since its inception—starting with trying to get healthcare consumers and insurers to understand what it has to offer that’s different from a traditional primary care practice or the emergency room. Through true market evolution—we’re talking Darwin, here—that hurdle has helped separate the wannabes from the real innovators. The latter came to grasp that a patient-friendly approach would be one obvious attribute that could keep waiting rooms full and good …
Read MoreUrgent Care Ownership: Corporations on the Rise, Physicians and Hospitals on the Decline
The urgent care industry—always revolutionary compared with other practice settings—is undergoing a revolution of its own. First, entrepreneurial physicians ruled the roost (recall the much-maligned and unfairly categorized “doc in a box”). Then, hospitals figured out they were missing the boat on the practice and financial benefits of the urgent care approach and began acquiring or building their own urgent care centers. As of 2016, though, corporate ownership is most prevalent, followed by physician and …
Read MoreClarifying the Coding for Splint and Cast Application by Nonphysicians
Q: I would like clarification on an article I read in The Journal of Urgent Care Medicine (JUCM) online archive. The article, Splint and Cast Application Performed by Someone Other than Physician, referenced that nonphysician staff could bill for splint and cast application. Will you please expand on the references and confirm that we can bill for splint and cast application if it is done by someone on staff other than the physician? A: Yes, …
Read MoreWhich Way to Go: The Pros and Cons of 1099 vs W-2 Income for Urgent Care Physicians
Urgent message: To avoid running afoul of labor and tax laws, urgent care operators should understand what constitutes an “independent contractor” vs an “employee” and classify and pay their physicians appropriately. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Introduction Many smaller, independent urgent care providers pay their physicians under 1099 arrangements rather than with W-2 income. There are …
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Establishing Success Habits for Leaders and Organizations
Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: High achievers across industries and professions all share a common trait: the ability to leverage the power of habit to ingrain positive behaviors that lead to success. Hence, urgent care operators that can cultivate great habits in themselves and their teams effectively lay the foundation for a thriving …
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Developing a Reimbursement Policy for CME and Other Employee Expenses
Urgent message: Every urgent care center should have a clear policy outlining which employee expenses, including CME-related expenses, it reimburses and how reimbursement occurs. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Managers, owners, and supervisors in nearly every field need to be familiar with the process of reimbursing employees for costs incurred while doing company business. Whether …
Read MoreNew Medicare Cards
Q: The Centers for Medicare and Medicaid Services (CMS) started issuing new Medicare cards to beneficiaries in April of this year. What do I need to know about these changes to limit disruption to my patients and medical practice? A: CMS is required to issue new Medicare cards as a part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which mandates that CMS remove Social Security Numbers (SSN) from all Medicare cards …
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The Effect of PECARN Guidelines on Minor Head Injury Referrals from the Urgent Care Center to the Emergency Room
Cathleen DeLaney DNP, MSN-FNP, APRN and Kris Skalsky MSNEd, EdD, RN Abstract Background and Purpose: The focus of this project was to determine if an evidence-based educational intervention had an impact on reducing the number of pediatric head injury referrals from the urgent care center to the emergency room. The urgent care center often makes referrals of pediatric head injury patients to the ED, contributing to the overutilization and overcrowding of an already taxed system. …
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