Developing Data: April, 2012
These data from the 2010 Urgent Care Benchmarking Survey 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” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. In this …
Read MoreMedicare Modifier PD, Fracture Visit Coding, Coding for Emergent Transport, ‘Big Ticket’ Reimbursement Codes, Medicare CLIA-Waived Codes
DAVID STERN, MD (Practice Velocity) Q. What is the new modifier PD? A. If your urgent care center is owned by a hospital or health system, then Medicare has a new modifier for your center. The new HCPCS Level II Modifier PD is defined as a “diagnostic or related non-diagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within 3 days, or …
Read MoreAbstracts in Urgent Care: April, 2012
Normalization of Vital Signs Does Not Reduce Risk for Acute Pulmonary Embolism Key point: Up to one-third of patients whose abnormal triage vital signs reverted to normal values had PE. Citation: Kline JA, Corredor DM, Hogg MM, et al. Normalization of vital signs does not reduce the probability of acute pulmonary embolism in symptomatic emergency department patients. Acad Emerg Med. 2010; 19(1): 11-17. In a prospective single-center study, researchers evaluated whether normalization of vital signs …
Read MoreCuring ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP So you missed the “cancer.” Maybe you still don’t even know you missed it. At this point the patient (your business) is dying and you plod along unaware of the impending doom, like a smoker with a chronic cough. Your business is losing weight, its cheeks are sunken, skin sallow, as it grows weaker each passing month. One day soon it will start coughing up blood, and then it …
Read MoreClinical Challenge: April, 2012
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of determining conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, a 45-year-old man, presented with vomiting and chest pain. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the …
Read More
5-year-old male exhibits irritability and persistent febrility
The patient was a 5-year-old male. His parents reported that he had been febrile for the past several days (fever between 101°F and 103°F [38.3°C to 49.4°C]) and had become increasingly irritable and ill appearing. Exam revealed bilateral conjunctival injection without exudate, dry red lips and red tongue, and perineal erythema with overlying scale. The patient’s lymph nodes were swollen. View the images taken (Figures 1, 2 and 3) and consider what your diagnosis would …
Read MoreClinical Challenge 2: March, 2012
The patient, a 21-year-old female, presented with trauma to her right wrist. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
Read MoreWhen Serious Pathology Masquerades as a Minor Injury
Urgent message: The patient punctured his hand with a power screwdriver. It turned out to be the least of his problems. Frank Fannin, MD, EMT-P Introduction Hand Injuries are common and a major concern in urgent care settings as a source of potential significant disability and liability. A detailed history and focused exam are paramount to appropriate treatment and disposition. In the following case, a potentially devastating finding turns out not to be all that …
Read MoreWorkplace Bullying and its Costs to the Urgent Care Operation
Urgent message: More than one third of U.S. employees say they have been bullied in the workplace. Does your practice have a policy in place to thwart this insidious problem? If not, it should. Alan A. Ayers, MBA, MACC What is the Difference Between Diversity and Tolerance? According to one definition, diversity is anything that makes you different while tolerance is not persecuting people who are different. Many urgent care operations strive for a unified …
Read More