Q.We always get denials for the E/M code in addition to a procedure. Are we doing something wrong? A.Denials for payment for an E/M in addition to a procedure may stem from several sources: Missing modifier If you perform a procedure with a 0- or 10-day global period and you perform and document a separate E/M on the same day, always attach modifier -25 to the E/M to reduce denials and costs of rebilling. Use …
Read MoreProtecting Yourself Against Medical Malpractice Claims, Part 2
In the December issue of JUCM, Dr. Shufeldt introduced a discussion on how to not be named in a malpractice suit by suggesting that providing excellent customer service, never saying “no” to a patient, and thorough documentation of the pertinent positives and negatives are viable techniques to reduce your malpractice exposure. Here, he continues the discussion with other precautions you can take. Failure to make an appropriate referral is a reason commonly cited when providers …
Read MoreEmergencies in the Office: Why Are 911 Calls Placed From Family Medicine and Urgent Care Offices?
Urgent message: New data indicate that calls to 911 from family medicine and urgent care offices and subsequent transport to ED occur for a wide range of reasons, with the distribution varying to a large degree based on the age of the patient and the practice setting. Introduction Life-threatening emergencies have been reported to occur in primary care medical offices.1,2 However, the type of medical emergencies that occur remains unclear. Previous studies that have attempted …
Read MoreEpididymitis-The Optimal Urologic Evaluation Management Approach in the Urgent Care Setting
Urgent message: Though epididymitis is clinically non-urgent, its symptoms are driving more and more men to urgent care, making it imperative that providers are familiar with its epidemiology, etiology, evaluation, and treatment. Introduction Epididymitis is among the most frequently diagnosed and treated conditions in men. Typically, men present to, and are diagnosed and treated by, their primary care physicians or their urologist. Treatment is with antibiotics on an outpatient basis. Epididymitis is, in general, non-life …
Read MoreOn Stone Passage, Wait-and-See Prescriptions, Foreign Bodies, and Wireless Prescribing
Medical Therapy to Facilitate Urinary Stone Passage: A Meta-analysis Citation: Hollingsworth JM, Rogers MA, Kaufman SR, etal. Lancet. 2006;368:1171-1179. URL: http://www.thelancet.com/journals/lancet/article/PIIS0140673606694749/abstract Key point: Medical therapy is an option for facilitation of urinary-stone passage. Medical therapies to ease urinary-stone passage have been reported, but are not generally used. If effective, such therapies would increase the options for treatment of urinary stones. The authors searched MEDLINE, Pre-MEDLINE, CINAHL, and EMBASE, as well as scientific meeting abstracts, up …
Read MoreKeeping Your Ear to the Customer
FRANK H. LEONE, MBA, MPH “Keep your ear to the customer” is a central tenet of effective marketing. Awareness of how your services are used and valued can be especially important in a field like occupational medicine, where the people you treat are often not the ones who contract for those services. There are many ways to keep your ear to the customer, and there are many customer subgroups. “Customers” might include patients, employers, carriers/payors, …
Read MoreProtecting Yourself Against Medical Malpractice Claims, Part 2
JOHN SHUFELDT, MD, JD, MBA, FACEP In the December issue of JUCM, Dr. Shufeldt introduced a discussion on how to not be named in a malpractice suit by suggesting that providing excellent customer service, never saying “no” to a patient, and thorough documentation of the pertinent positives and negatives are viable techniques to reduce your malpractice exposure. Here, he continues the discussion with other precautions you can take.
Read More
Epididymitis: The Optimal Urologic Evaluation Management Approach in the Urgent Care Setting
Urgent message: Though epididymitis is clinically non-urgent, its symptoms are driving more and more men to urgent care, making it imperative that providers are familiar with its epidemiology, etiology, evaluation, and treatment. Richard A. Schoor, MD, FACS, Private Practitioner, Smithtown, NY Epididymitis is among the most frequently diagnosed and treated conditions in men. Typically, men present to, and are diagnosed and treated by, their primary care physicians or their urologist. Treatment is with antibiotics on …
Read MoreJanuary 2007
Keeping the Joy of Practice
Many physicians in urgent care face burnout. While the numbers are probably far less than our emergency medicine colleagues, the burdens of productivity, quality, patient satisfaction, employee satisfaction, and risk management can weigh heavily on urgent care physicians, and with time, take the joy out of practicing. This is the first in a series of editorials providing practical tips for reducing “urgent care fatigue syndrome.” Let’s start with an approach to managing patients who are …
Read More