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 MoreModifier for 69210, HCPCS for IM Zofran, S9088 vs 99051, and Billed Amount for 99051
Q.What modifier can I use for CPT Code 69210 (removal impacted cerumen, [separate procedure], one or both ears) for Medicare? I used left and right, but the claim was denied as an incorrect modifier. A.Because the definition of the code includes either or both ear(s), you should not attach a modifier to indicate the right (-R), left (-L), or bilateral (50) ear(s). Q.My physicians like to give Zofran injectable intramuscular; we generally don’t give it …
Read MorePotential Pitfalls While Finding the Needle in the Haystack
JOHN SHUFELDT, MD, JD, MBA, FACEP It’s nearly midnight on Saturday and I am between patients in an ED on an unseasonably cold November evening in Phoenix, Arizona. Among the head bleeds, overdoses, MI’s, and strokes, I have had these chief complaints thrown at me: “Smoke inhalation after blowing out a candle” “I can’t stop playing with my number one.” “I’m here for my 40-year-old physical.” (The patient was 43.) “I fell asleep at a …
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An Urgent Care Lab as a Profit Center?
Urgent message: An onsite lab can generate significant revenue for your practice. Lab expert Tim Dumas shows how. TIM DUMAS, MLT,CLS Introduction I have been a lab tech for almost 35 years and serve as advisor to 45 physician office labs around the country. I have seen many changes in that time, most for the better. Thirty—even 20—years ago, a stat CBC with differential was a 15-minute-procedure and required a skilled lab tech to get …
Read MoreDeveloping Data: November, 2011
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 on-site; 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 MoreNebulizer Supplies, Diltiazem IV, Influenza Vaccines with E/M Codes, and Critical Care Coding in Urgent Care
Q.I am using an EHR, but it does not seem to code nebulizer treatments correctly. It produces codes 94640 (nebulizer treatment) and J7620 (albuterol/ipra – tropium bromide), but it misses the codes for administration set, with small volume non-filtered pneumatic nebulizer, disposable (A7003) and tubing (A7011 ). Why is this? A.The administration set code (A7003) and tubing code (A7011) code are actually bundled into the code for the treatment (ie, they are included in 94640). …
Read MoreAequanimitas*
“Thou must be like a promontory of the sea, against which, though the waves beat continually, yet it both itself stands, and about it are those swelling waves stilled and quieted.” —Marcus Aurelius It is important to reflect occasionally on where one’s path began inasmuch as we owe a debt to those who have advanced our current purpose, whether family, business, or profession. The goal of this reflection should hopefully include an appreciation of …
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A Better Way to Settle Malpractice Suits?
Urgent message: Mediation could produce better outcomes than litigation for patients and physicians—if doctors would only show up. CAROL B. LIEBMAN, JD Introduction A stomach pain is misdiagnosed as viral gastroenteritis. The patient ends up in the hospital for six days with complications from a ruptured appendix. A physician prescribes penicillin to a woman with clearly documented allergies, which leads to anaphylaxis and a day in the ICU. A severe headache is labeled a migraine; …
Read MoreRule Number One: Code for Services Rendered
DAVID STERN, MD (Practice Velocity) Q.Which CPT codes can be used for diagnosis codes 786.50 (unspecified chest pain) and 414.9 (chronicischemic heart disease-unspecified) to maximize a Medicare patient bill? A.The basic rule of coding is that you should code for the services rendered, not to “maximize a patient bill.” In other words, you should code the best codes that indicate the actual services that were performed. For these codes, you could code for a cardiac …
Read MoreDeveloping Data: October, 2011
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,” the qualifications for which included accepting walk-ins during all hours of operation, as well as having a licensed provider on site, x-ray and labs on site, the ability to administer IV fluids and perform minor procedures, and being open seven days a week, …
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