Coding Concerns: Versajet Debridement, Time Frame for New/Established Patients, Detailed Exams, Denial of S9088, –57 Modifier, and Billing for Injections

DAVID STERN, MD (Practice Velocity) Q.How do I code when using Versajet to debride an ulcer? A.For Versajet debridement, you should report CPT code 97597 (removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., high-pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel, and forceps), with or without topical application(s), wound assessment, and instruction(s) for ongoing care, may include use of a whirlpool, per session; total wound(s) surface area less than or …

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Innovation in Occupational Health Marketing

In a recent episode of the popular television show Mad Men, super ad man Don Draper opined to his up-and-coming colleagues that “marketing is all about innovation.” He’s right. But the best-laid plans often sink into the abyss of the “same old, same old.” After all, if marketing is about distinguishing one’s organization from its competitors, why not rely on the tried and true to punctuate the difference? This reasoning is flawed, however; marketing should …

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Accountable Care Organizations, Where do Urgent Care Centers Fit?

JOHN SHUFELDT, MD, JD, MBA, FACEP Under the Affordable Care Act, the Centers for Medicare and Medicaid Services will pioneer a number of new projects which affect the delivery of healthcare in the United States. Among these projects, the most ambitious is the proliferation of the Accountable Care Organizations (ACOs). Other initiatives include pay-for-performance (P4P) and quality improvement agendas proffered by organizations responsible for accreditation, all focusing on clinical delivery pathways or “care paths.” The …

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Developing Data: February, 2011

In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we continue looking into data brought to light in Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics,1 an article that (as the title implies) compared the capabilities and usage of urgent care centers vs. other immediate-care options the U.S. It may be most valuable to the urgent care …

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Say ‘Arrivederci’ to Printed Materials

An interesting title for a book addressing the impact of the electronic information age might be The End of Paper. Look around. Daily newspapers are dramatically down in circulation and shutting down at a rapid rate. That 20-volume encyclopedia that used to sit on your parents bookshelf? No mas. Those written assignments at every school level? A thing of the past. Seems like a no brainer. Out with the paper and in with the electronic …

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Like Super Good Written, Verbal and Non-verbal Communication and Stuff

JOHN SHUFELDT, MD, JD, MBA, FACEP I will begin this short essay by admitting that I am not always the best or most appropriate in terms of my style or manner of communication, which is no news to my two relatives who make up half the readership of these articles. I have also learned over the years to take most things with a grain of salt (particularly if it is followed by a shot of …

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Coding for Intravenous Infusion, Fees for S9083, Morgan Lens Irrigation, and UB-04 Revenue Codes for Urgent Care

DAVID STERN, MD (Practice Velocity) Q.I had a patient come in who needed IV fluids and monitoring for five hours. We found the CPT codes 96360 (intravenous infusion, hydration; initial 31 minutes to 1 hour) and 96361 (each additional hour…) to use for the IV hydration therapy. However, my doctor cannot believe how low these codes are reimbursed by his health insurance. We did bill an office visit in addition to the IV. Is this …

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Developing Data: January, 2011

In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we begin delving into a report whose top-line data made headlines around the country recently. The article, Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics,1 went beyond the conclusion stated in its title, offering a snapshot of how patients exercise their freedom to choose among those three settings. …

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Using the New Media: A Modern Plan

Adaptability is defined as the ability “to adjust to new conditions or a different environment.” It is a word that should be ingrained in the mindset of any sales-minded urgent care clinic. I believe that lack of adaptability is the primary cause of less than stellar sales and marketing initiatives. In a business world that is changing daily, yesterday’s approach is, well, so yesterday. You need to adapt quickly to our rapidly changing environment. Right …

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Management v. Leadership, 558 U.S. 461 (2010)

JOHN SHUFELDT, MD, JD, MBA, FACEP Recently, I had the amazing opportunity to be admitted to the Bar of the United States Supreme Court, which simply means that I could conceivably argue cases in front of the Court. After being sworn in by Chief Justice Roberts, our group of newly admitted attorneys was privileged to have front-row seats to hear two landmark cases, the second of which I will share with you in detail. The …

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