Journal of Urgent Care Medicine

Developing 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 …

Nebulizer 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). …

Aequanimitas*

“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 …

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; …

Rule 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 …

Developing 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, …

Selling Your Urgent Care? Here’s What’s Involved

JOHN SHUFELDT, MD, JD, MBA, FACEP A large urgent care group has just offered to buy your centers. So now what? First, get some advice. This process is incredibly time-consuming inasmuch as the amount of material and the degree of detailed information required before a sale is consummated is daunting. Also, the way you position and promote your center and the thoroughness of your disclosures will speak volumes about your abilities and will ultimately be …

Take Patient Satisfaction to the Next Level

Urgent message: Companies like Apple and Nordstrom have raised the quality of customer experience to an art form, one that urgent cares would do well to emulate. ALAN A. AYERS, MBA, MACC, Experity Introduction Urgent care is positioned as a consumer-focused delivery channel for low-acuity medical services differentiated from hospital emergency departments and primary care practices by retail-facing locations, extended evening and weekend hours, and walk-in convenience. As with airlines, restaurants, and other service businesses, …

Developing Data: September, 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 …

Medical Necessity in E/M Coding, Part 3: Correctly Coding the Physical Exam

DAVID STERN, MD (Practice Velocity) Some coding auditors do not understand the urgent care setting. As a result, they have been inappropriately downcoding evaluation and management (E/M) levels— not based on levels of documentation, but rather on whether the documentation is supported by their “view” of medical necessity, even though these auditors have usually never been providers and lack clinical experience. In this situation, the best defense is a strong offense. This column reviews medical …