A new year always brings changes, and CPT is not excluded. On January 1, 2017 you will want to take note of CPT code changes that will affect your billing. Imaging Guidance Codes with Puncture Aspiration If guidance is used for needle placement when performing puncture aspiration CPT code 10160, “Puncture aspiration of abscess, hematoma, bulla, or cyst,” coders are directed to the imaging guidance codes: 76492, “Ultrasonic guidance for needle placement (eg, biopsy, aspiration, …
Read MoreUrgent Care Seasonality: Monthly Average Visits as a Percentage of Average Daily Visits
The following chart, based data from a Practice Velocity study of more than 20,000,000 patient visits over a 5-year period, shows that urgent care exhibits a strong pattern of seasonality. The average daily visits in each month vary from average daily visits over the course of a year. For example, on an average day in July, there are 14% fewer patients than the baseline number, whereas in an average day in December, there are 25% …
Read MoreThe Effects of the National Correct Coding Initiative
Q. I understand that the Centers for Medicare & Medicaid Services has added National Correct Coding Initiative (NCCI) edits that no longer allow the billing of debridement with hundreds of surgical codes. What is the impact? How do NCCI edits affect us in general? A. NCCI edits define when two procedure codes may not be reported together except under special circumstances. Medicare implemented NCCI to promote national correct coding methodologies and to control improper coding, …
Read MoreExtreme Caution: The HIPAA Dos and Don’ts When Responding to a Subpoena for Patient Medical Information
Urgent message: When health-care providers or urgent care centers respond to subpoenas for patients’ medical information, it is vital that they respond promptly, respond with exactly the information requested and nothing more, and protect patients’ privacy and confidentiality. Introduction When producing documents in response to a subpoena demanding patient medical information, a health-care provider must know the dos and don’ts to avoid privacy and confidentiality violations, sanctions, and penalties. A subpoena is a court or …
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Making Your Urgent Care Center Welcoming for LGBTQ Patients
Urgent message: There is a growing need for awareness of medical, safety, and social issues involving the lesbian, gay, bisexual, transgender, and queer community in health care. Here’s how urgent care fits in. Introduction There are significant unmet health needs among members of the U.S. lesbian, gay, bisexual, transgender, and queer (LGBTQ) population, many of whom are afraid to access the health-care system and face barriers to care even if they do seek treatment. Clearly …
Read MoreFlu as a percentage of total visits
The following chart, based on a study of over 20,000,000 patients’ records in Practice Velocity’s database of patient visits across the United States, illustrates the frequency of influenza diagnoses between January 2010 and October 2016 relative to total urgent care visits that carried an evaluation and management (E/M) code. The period of December through January is the typical peak of the flu season, although in some years flu outbreaks occur somewhat earlier or later. In …
Read MoreImaging: X-Rays and Computed Tomography
Q. I understand that there will be reductions for x-ray reimbursements from Medicare in 2017. Is this true? A. To give imaging providers an additional incentive to adopt more advanced x-ray technology, Medicare will reduce reimbursement, beginning in 2017, for the technical component (and the technical component of the global fee) in claims submitted for x-rays performed with analog equipment. The cuts will continue in future years for those using computed radiography equipment (Table 1). …
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Understanding the Impacts of Health-Care Reform on Urgent Care
Urgent message: Urgent care plays a vital role in reducing medical expenses and improving population health by enabling the right care, at the right place, by the right provider, at the right price. Introduction Health-care reform, quality of care, and costs are center stage topics for politicians and the general public. As medical providers and administrators in the United States, we share in the challenge of understanding this complex system. Whereas traditional approaches in the …
Read MoreIncome Tax Liability from Phantom Income
Urgent message: How physician and entrepreneur investors structure their urgent care center may expose them to an income tax liability from phantom income, but there are steps they can take to ensure there are sufficient funds to cover it. Introduction Income taxes are one of life’s certainties for most working Americans. Typically, however, income taxes are paid only on cash received during the course of a year. For example, a Form W-2 received by an …
Read MoreMost Frequently Occurring X-Ray Views in Urgent Care
Availability of basic x-ray capabilities differentiates urgent care centers from walk-in primary-care and retail clinics, which lack such capabilities. According to an analysis of nearly 50,000 patient encounters by Practice Velocity and Teleradiology Specialists, approximately 11% of urgent care visits require an x-ray. The top 10 views, summarized here by Current Procedural Technology (CPT) codes, account for 86% of urgent care x-rays. (Note: The top 10 views include 11 views because of the equal percentage of …
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