Journal of Urgent Care Medicine

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

Rural Urgent Care Growth Continues, But Challenges Remain

Urgent Message: Rural urgent care is the industry’s fastest growing segment, influenced by rural primary care shortages, hospital closures and extended ED wait times, but operational staffing and reimbursement complexities must be navigated. Alan A. Ayers, MBA, MAcc Citation: Ayers A. Rural Urgent Care Grows, But Challenges Remain. J Urgent Care Med. 2024; 19(3): 17-21 As access to care in rural areas continues to decline, urgent care (UC) can play a pivotal role in the …

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

55-Year-Old With Wrist Pain

A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From Disc Herniation: A Case Report

Urgent Message: Abdominal pseudohernia is a rare diagnosis with variable presentation. Urgent care clinicians who are familiar with the condition and its variable presentations can reduce the risk of diagnostic errors and unnecessary or inappropriate diagnostic testing. Berkeley E Prewett, BSA; Stephen V Green, MD; Andrew L Juergens II, MD; Taylor K Ratcliff, MD Citation: Prewett BE, Green SV, Juergens AL, Ratcliff TK. Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From …

How ‘Data Reviewed’ Works When Coding E/M

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC Three elements determine the level for evaluation and management coding (E/M). “Amount and/or Complexity of Data to be Reviewed and Analyzed” is 1 of them and also the most confusing. Data Reviewed remained a point system after guidelines changed in 2021. As an auditor, I see both undercoding and overcoding in E/M caused by not applying the rules correctly. Let’s start with what tests count toward Data Reviewed. …

WellNow Returns to In-Network Status With Excellus BCBS

Breaking a 10-month stalemate, WellNow Urgent Care and Excellus BlueCross BlueShield (BCBS) have at last executed a new contract agreement, putting WellNow back in-network as of November 15, 2024, according to an email from WellNow. Excellus insurance plans covered about 300,000 WellNow visits in New York last year. At least 40 centers are located in Central New York where hospital closures in recent years have provided WellNow opportunities to fill gaps in access. “At WellNow …

Novant Acquires UCI, Adds 52 Urgent Care Clinics

Novant Health has completed its acquisition of UCI Medical Affiliates, Inc. (UCI), previously owned by BlueCross BlueShield of South Carolina. The deal includes 52 Doctors Care urgent care clinics and 20 Progressive Physical Therapy clinics. UCI also provides nonmedical management and administrative services specifically for urgent care and physical therapy operators. Charlotte-based Novant has 3 hospitals in South Carolina, so the urgent care additions will no doubt offer some new referral source potential. Staying the …

UH Building Up Urgent Care in Ohio to Match Cleveland Clinic

In the northern Ohio market, University Hospitals (UH) has paired with WellStreet Urgent Care to open a flurry of UH-branded urgent care centers in suburban locations. Within 2 years, the joint venture is aiming to have 36 UH urgent care centers open across the region—directly competing with the existing 36 centers currently operated by UH rival Cleveland Clinic, according to Cleveland.com. UH has selected sites near its primary care offices to better close the loop …

Zoning Upends Bon Secours Urgent Care Plans

Urgent care site selection can be tricky business. Once operators have sized up their addressable market, considered the competition, and estimated the available workforce, opening their doors may seem like a cinch. However, local zoning approvals must figure into site selection strategy as well. Last week, city councilors in Celina, Ohio, voted down a rezoning measure, which ultimately prevented Bon Secours Mercy Health from building a 4,200-square-foot urgent care on a former manufacturing site in …

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