DAVID STERN, MD (Practice Velocity) Q.Can 99283 and 99214 procedure codes be used for an urgent care visit? The codes were used by an urgent care facility, and I am told that 99283 is categorized as an emergency room code. A.Code 99283 is for an emergency department visit for the evaluation and management of a new or established patient with an expanded problem focused history and examination and medical decision making of moderate complexity. Code 99214 …
Read MoreHow to Get Sued for Malpractice: Four Studies In Self-Destruction
JOHN SHUFELDT, MD, JD, MBA, FACEP In the past, I have written about how to avoid getting named in a medical malpractice action. But it can often be instructive to view things from the opposite perspective. So this time, let’s turn it around and actually try to get named in a malpractice suit. It usually only takes one of the following misadventures: Practice bad medicine and have a bad outcome Practice good medicine, communicate/document poorly, …
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Dealing with the Disruptive Doctor
Urgent message: When a physician is dubbed “Tom the Terror,” turning a blind eye can send patients and staff heading for the exit, wreck your reputation, and spark a lawsuit. Here’s what to do instead.LEONARD D. GOODSTEIN, PHD, ABPP, and JOHN SHUFELDT, MD, JD, MBA, FACEP Tom P. is a competent, board-certified emergency physician. He is liked and respected by his patients. But Tom‘s relationships with staffers at the urgent care center where he still …
Read MoreEvery Man His Own Doctor
JOHN SHUFELDT, MD, JD, MBA, FACEP While treating patients in the emergency department, I occasionally marvel at the changes I have witnessed over my 25 years in medicine. Sometimes I think, “Thank God I did not treat you 25 years ago, because if I had, I would have done (fill in the blank), it would not have worked, and you would have probably hated every second of it.” I am as old as Moses, so …
Read MoreDeveloping Data: June, 2011
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we offer a look at data from the 2010 Urgent Care Benchmarking Survey Results. These data are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care centers,” the qualifications for which included accepting walk-ins during all hours of operation, as well as …
Read MoreMedical Necessity in E/M Coding, Part 2: ROS and PFSH
DAVID STERN, MD (Practice Velocity) Last month, we presented definitions for medical necessity offered by the AMA and the Centers for Medicare & Medicaid Services (CMS). We looked at the elements appropriate to perform and document in the History of Present Illness (HPI). And we briefly discussed Recovery Audit Contractors (RAC) audits. (If you missed it, the column is archived on the JUCM website [https://www.jucm.com] in the May 2011 issue.) This month, our focus is …
Read MoreDeveloping Data: May, 2011
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we offer a look at data from the 2010 Urgent Care Benchmarking Survey Results. These data are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care centers,” the qualifications for which included accepting walk-ins during all hours of operation, as well as …
Read MoreMedical Necessity in E/M Coding
DAVID STERN, MD (Practice Velocity) Q.Recently some of my charts were audited and the payor challenged the levels of the evaluation and management (E/M) codes I had used. The payor said that the charts were actually coded correctly, based on the information that was documented on the chart. The auditor, however, challenged what she called the “medical necessity” of the documentation. She claimed that, based on the patients’ chief complaints, many elements of the E/M …
Read MoreMalpractice Insurance: A Primer for Urgent Care Clinicians
JOHN SHUFELDT, MD, JD, MBA, FACEP The possibility of being sued for medical malpractice, while not a pleasant prospect, is not something that should be causing you sleepless nights. Much like flood insurance, malpractice insurance exists for times when an unexpected event occurs and may require some payment for damages. Your goal should simply be to have adequate coverage for those times. And, let’s face it, there may be such times. Good providers do get …
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Enhancing Profits with Immigration Physicals
Urgent message: Conducting immigration physicals can be surprisingly lucrative. These relatively high-priced, cash-only visits incur no insurance billing or accounts receivable carrying costs. And because they are scheduled, ebbs and flows in patient volume can be leveled. Here’s how it works. Alan A. Ayers, MBA, MAcc Practice Velocity The success of a new urgent care center in a community requires a change in consumer behavior, with a sufficient number of residents shifting their utilization from …
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