Journal of Urgent Care Medicine

Cost-Effective Staffing with Medical Assistants

Urgent message: Medical assistants (MAs) provide flexible, cost-effective clinical support for urgent care centers. With proper training and working under a physician’s supervision, an MA can perform most basic support functions in this setting. Introduction While there’s a lack of verifiable data as to the total number of unsuccessful urgent care endeavors, we can presume at least one common reason urgent care centers shutter their doors and permanently cease operations: they exhaust their working capital. …

100 Largest Urgent Care Center Operators

The 100 largest urgent care operators in the United States run approximately 25% of the locations under their banners, according to research by Practice Velocity and National Urgent Care Realty. They’re getting even bigger, too; the number of locations owned by the companies on the list expanded by about 20% this year. While ownership was once delineated between hospital-affiliated and independents, several multi-unit operators now operate in some (but not all) of their markets as …

2017 Current Procedural Terminology (CPT) Code Changes

A new year always brings changes, and CPT is not excluded. On January 1, 2017 you will want to take note of CPT code changes that will affect your billing. Imaging Guidance Codes with Puncture Aspiration If guidance is used for needle placement when performing puncture aspiration CPT code 10160, “Puncture aspiration of abscess, hematoma, bulla, or cyst,” coders are directed to the imaging guidance codes: 76492, “Ultrasonic guidance for needle placement (eg, biopsy, aspiration, …

Urgent Care Seasonality: Monthly Average Visits as a Percentage of Average Daily Visits

The following chart, based data from a Practice Velocity study of more than 20,000,000 patient visits over a 5-year period, shows that urgent care exhibits a strong pattern of seasonality. The average daily visits in each month vary from average daily visits over the course of a year. For example, on an average day in July, there are 14% fewer patients than the baseline number, whereas in an average day in December, there are 25% …

The Effects of the National Correct Coding Initiative

Q. I understand that the Centers for Medicare & Medicaid Services has added National Correct Coding Initiative (NCCI) edits that no longer allow the billing of debridement with hundreds of surgical codes. What is the impact? How do NCCI edits affect us in general? A. NCCI edits define when two procedure codes may not be reported together except under special circumstances. Medicare implemented NCCI to promote national correct coding methodologies and to control improper coding, …

Extreme Caution: The HIPAA Dos and Don’ts When Responding to a Subpoena for Patient Medical Information

Urgent message: When health-care providers or urgent care centers respond to subpoenas for patients’ medical information, it is vital that they respond promptly, respond with exactly the information requested and nothing more, and protect patients’ privacy and confidentiality. Introduction When producing documents in response to a subpoena demanding patient medical information, a health-care provider must know the dos and don’ts to avoid privacy and confidentiality violations, sanctions, and penalties. A subpoena is a court or …

Flu as a percentage of total visits

The following chart, based on a study of over 20,000,000 patients’ records in Practice Velocity’s database of patient visits across the United States, illustrates the frequency of influenza diagnoses between January 2010 and October 2016 relative to total urgent care visits that carried an evaluation and management (E/M) code. The period of December through January is the typical peak of the flu season, although in some years flu outbreaks occur somewhat earlier or later. In …

Imaging: X-Rays and Computed Tomography

Q. I understand that there will be reductions for x-ray reimbursements from Medicare in 2017. Is this true? A. To give imaging providers an additional incentive to adopt more advanced x-ray technology, Medicare will reduce reimbursement, beginning in 2017, for the technical component (and the technical component of the global fee) in claims submitted for x-rays performed with analog equipment. The cuts will continue in future years for those using computed radiography equipment (Table 1). …

Understanding the Impacts of Health-Care Reform on Urgent Care

Urgent message: Urgent care plays a vital role in reducing medical expenses and improving population health by enabling the right care, at the right place, by the right provider, at the right price. Introduction Health-care reform, quality of care, and costs are center stage topics for politicians and the general public. As medical providers and administrators in the United States, we share in the challenge of understanding this complex system. Whereas traditional approaches in the …

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