Abstracts in Urgent Care: May, 2011
Complications of Sinusitis in Children Key point: Intracranial complications of pediatric sinusitis were more severe than intraorbital complications. Citation: Goytia VK, Giannoni CM, Edwards MS. Intraorbital and intracranial extension of sinusitis: Comparative morbidity. J Pediatr. 2011;158(3):486-491. Serious complications of sinusitis occur more often in children than in adults. Prompt diagnosis and treatment are necessary to minimize morbidity and the risk for permanent sequelae or death. In arecent study, investigators reviewed records from a large chil- …
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 MoreClinical Challenge: May, 2011
The patient is an otherwise healthy child, 3.5 years of age, who presents with acute pain in his right lower arm to the elbow. Examination reveals multiple fractures. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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 …
Read MoreBurns: Their Evaluation and Treatment in Urgent Care
Urgent message: Most burn injuries can be handled in an outpatient setting—if they are classified accurately, treated appropriately, and referred to a regional burn center when indicated. TRACEY QUAIL DAVIDOFF, MD A “burn” is defined as a traumatic, thermal injury to the skin and deeper structures. Some or all of the cells of the skin can be destroyed not only by heat but also by cold, chemicals, electricity, or radiation. Burns are the third-leading cause …
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32-year-old patient sustains blow to chest
This 42-year-old patient suffered a blow to the chest and presents with pain but is assumed to be otherwise healthy. View the image taken and consider what your diagnosis and next steps would be.
Read MoreCase Report: A 17-year-old Boy with Pneumomediastinum
Urgent message: Although free air in the mediastinum is generally a benign, self-limited condition, most patients should be admitted to the hospital and observed for signs of serious complications, which could be fatal. By Tracey Quail Davidoff, MD A previously healthy 17-year-old male presents to urgent care with a one-week complaint of sore throat, fever, and nasal congestion. On the last day, he had experienced sharp chest pain, which worsened with deep inspiration, swallowing, and …
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