Coding for Rectal Strep and Injury Exposure Visits, Billing for Slit Lamp Exams, and a Follow-up on Splinting

DAVID STERN, MD (Practice Velocity) Q. What is the correct ICD-9 code for rectal strep? Question submitted by Cindy Reisbeck, Littleton, CO A. There are several possible codes. The specific ICD-9 code would depend on a more specific diagnosis. For streptococcal infections in the rectal or perirectal area, there are several possible correct codes, as streptococcal species can cause multiple different types of localized conditions. For cellulitis, the correct code would be 566; for erysipelas, …

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Developing Data: July/August, 2010

In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we provide new data relevant to many urgent care providers’ marketing messages – namely, hospital performance on wait times during visits to the emergency room. These data reflect the percentage of visits in which wait times met pre-defined targets. Source: Horwitz LI, Green J, Bradley EH. U.S. emergency department performance on wait time and …

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Coding for Splints, Modifier–QW, Routine Rechecks, and Language Barriers to Efficient Coding

DAVID STERN, MD (Practice Velocity) Q. For splinting, our physicians use Ortho-Glass. At one time we billed out by the inch for it, but now some are saying that you cannot bill for it, as it is included in the E/M level charge. This does not make sense to me, so we’re looking for an expert opinion. Can you help me with this coding dilemma or point me in the right direction? Question submitted by …

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Transitions

John Shufeldt, MD, JD, MBA, FACEP I participated in my first triathlon in 18 years last weekend in a town named for a card game. Show Low sits at 6,412 feet at the base of the White Mountains in northern Arizona. Remember the first scene in Chariots of Fire, where a group of men are running barefoot, effortlessly through the crashing waves on a beautiful beach with the orchestra playing an inspiring melody in the …

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Agencies Can Extend Clinical Recruiting and Staffing Capabilities

Agencies Can Extend Clinical Recruiting and Staffing Capabilities

Urgent message: Medical staffing agencies extend an urgent care center’s recruiting and staffing capabilities with solutions to fill all operating hours with qualified providers. Alan A. Ayers, MBA, MAcc Practice Velocity Introduction The United States faces a shortage of primary care and emergency medicine physicians – the provider force feeding urgent care. When an urgent care center has an insufficient number of providers to adequately cover its schedule, the patient experience suffers due to extended …

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Developing Data: June, 2010

IN early 2008, UCA revamped its annual survey in conjunction with researchers at Massachusetts General Hospital and Harvard University with the goal of assuring that the UCA Benchmarking Committee’s efforts produced a scientifically valid report. Here, we present some of the data from this landmark survey. As reported in the May installment of Developing Data, 93.3% of urgent care centers offer lab tests of one kind or another on the premises. In March, we told …

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Coding for ‘Feared Complaint,’ Facility E/M Codes, and Nuances in Complexity of Medical Decision-making

DAVID STERN, MD (Practice Velocity) Q. We recently coded a visit for a young woman who thought – although she had no symptoms or foreign-body sensation – that there was a tampon left in her vagina. On pelvic exam, however, no retained tampon was found. What ICD-9 code is appropriate? Should the physician still diagnose this as a foreign body in the vagina? Question submitted by Japhlet Aranas, Resurrection Healthcare, Illinois A. One should not …

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Harmony in the Urgent Care

John Shufeldt, MD, JD, MBA, FACEP My kids might offer a dissenting opinion, but I think I am pretty hip. And, although I have no idea what these lyrics mean … I want your ugly I want your disease I want your everything As long as it’s free I want your love Love-love-love I want your love … I still have Lady Gaga on in my iTunes. In fact, I kind of like these lyrics; …

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Turning Rejection Into Opportunity

A quarter of a century ago, a former colleague of mine who specialized in stress management told me that everyone experiences stress; what matters is how one manages it. Analogous advice would seem to apply to sales: “Every sales professional experiences rejection. What matters is how they manage that rejection.” This month’s column features a plan for learning how to live with rejection, and turning it to your advantage.

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