Journal of Urgent Care Medicine

The Game Part 3

JOHN SHUFELDT, MD, JD, MBA, FACEP Lawyer: Now doctor, isn’t it true that when a person dies in his sleep, he doesn’t know about it until the next morning? Lawyer: Doctor, how many autopsies have you performed on dead people? Witness: All my autopsies are performed on dead people. Lawyer: Do you recall the time that you examined the body? Witness: The autopsy started around 8:30 p.m. Lawyer: And Mr. Johnson was dead at the …

2013 Physical Therapy G Codes

DAVID STERN, MD (Practice Velocity) Q. We offer Physical Therapy services to patients in our urgent care center and some patients have Medicare insurance. I understand there are new codes that we must use for Medicare. What are they and how do we use them? A.The Centers for Medicare and Medicaid Services (CMS) was mandated by the Middle Class Tax Relief Act of 2012 to collect information regarding beneficiaries’ function and condition, therapy services furnished, …

Developing Data: July/August, 2013

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). In …

Developing Data: June, 2013

Foreign Body Removal, Hydration, and Minor Surgical Procedures with E/M

DAVID STERN, MD (Practice Velocity) Q. We removed an earring that was imbedded in the pinna using general anesthesia? Can we bill CPT code 69205? A.No. CPT code 69205, “Removal foreign body from external auditory canal; with general anesthesia,” is limited to the external auditory canal. The pinna, which also may be referred to as the auricle, is not considered a part of the auditory canal. If an incision was made to remove the embedded …

The Game Part 2

JOHN SHUFELDT, MD, JD, MBA, FACEP I used to love to watch Raymond Burr in “Perry Mason.” He would get some poor witness on the stand and, in the middle of her testimony, look at the jury while he handed the witness an incriminating document and say very loudly, “What about this?” At which point the witness would dissolve into tears with her head in her hands and confess to basically everything including the crime …

Creating Value By Adding Physical Therapy to Urgent Care – Part 1: Initial Considerations & Rationale

Urgent message: Many urgent care clinics face new competition and the landscape for reimbursement is changing. One tactic for enhancing profitability is to consider the addition of new services. Adding Physical Therapy to your practice can result in more satisfied patients, better clinical outcomes and a stronger bottom line. LAUREL STOIMENOFF, PT and HILARY HELLMAN, SLP Eighty percent of Americans will experience low back pain at some time in their lives. Many of these patients …

Developing Data: May, 2013

Mid-level Providers, Resident Providers, Non-payment for S9088, Non-payment for E/M 99205, POS -20 for Family Practice

DAVID STERN, MD (Practice Velocity) Q. Our urgent care is staffed by nurse practitioners (NP) 6 days per week and all of the billing is processed under the medical director for all insurance companies. I have three separate questions: Is it legal for a new Medicare patient entering the ur- gent care setting to be billed under the medical direc- tor if he is not on site and has never seen the patient? Is it …

The Game Part 1

JOHN SHUFELDT, MD, JD, MBA, FACEP In the movie The Game, Nicholas Van Orton (played by Michael Douglas) is a very wealthy and successful businessman. Unfortunately, his successes come at the cost of his family life and close, personal relationships. His brother, Conrad (played by Sean Penn), gives him a gift on his 48th birthday. The gift is enrollment into a live-action game where Nicholas is the principal player. This game initially consumes then seemingly …