DAVID STERN, MD (Practice Velocity) Q. Our physician did a shave excision and sent it to pathology. It came back as malignant. She now wants to bill using the destruction codes of 17260-17286. We coders are trying to tell her that she needs to bill for the shave excision, because she documented clearly that she performed shave excision. What is the correct way to bill for this procedure? Name withheld A. Per CPT Assistant 2009: …
Read MoreThe Checklist – Part 3
John Shufeldt, MD, JD, MBA, FACEP (Dr. Shufeldt began a three-part discussion of the importance of procedural checklists in the September issue of JUCM. The first two installments are available at www.jucm.com). Billy was a cocky, disingenuous, trying-to-be aviator who had a hangar next to mine until he left in the middle of the night to avoid paying his overdue invoices. I like pretty much everybody, at least initially. Despite trying, I did not like …
Read MoreDeveloping Data: October, 2010
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we relay data that track patient satisfaction with the emergency room based on time of day respondents arrived for treatment. Source: Pulse Report 2009: Emergency Department. Patient Perspective on American Health Care and Emergency Department Pulse Report 2007. Patient Perspectives on American Health Care. Press Ganey Associates, Inc. While these data do not …
Read MoreICD-9 Updates for 2011
DAVID STERN, MD (Practice Velocity) Updates to the ICD-9 code set went into effect October 1, 2010. There will be one more regularly scheduled ICD-9 update on October 1, 201, the vastly larger ICD-10 code set is scheduled to take effect. The following are changes that are of particular interest to us in the urgent care field: New code to specify post-traumatic seizures: When a patient experiences seizure(s) as a result of a head injury, …
Read MoreJust Say ‘No’ to Cold Calls
In sales, the term “cold call” may mean different things to different people. I define a cold call as an unannounced visit to a prospect company, whether the intention is to seek an unscheduled meeting or to drop off literature and/or gifts. I do not consider an initial telephone call a cold call, presuming it follows an introductory letter and/or email correspondence advising the prospect of the impending call.
Read MoreThe Checklist – Part 2
John Shufeldt, MD, JD, MBA, FACEP (Dr. Shufeldt began a three-part discussion of the importance of procedural checklists in the September issue of JUCM. That column is available at www.jucm.com.) I went to Mardi Gras two years ago. One of the events I attended was called the MOMs Ball. MOMs is an acronym for Mystic Orphans and Misfits; it’s a party by invite only, and only those with costumes and ticket are admitted. I was …
Read MoreDeveloping Data: September, 2010
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we present data that shed light on reasons parents may be taking their children to the emergency room instead of to their pediatricians, even for non-urgent care. Researchers at Columbia University Medical Center in New York City report that between 1997 and 2006, there’s been a shift in those reasons; where perceived need for …
Read MoreUnderstanding the True Value of the Occupational Health Product
Your clinic needs to sell occupational health services based on their perceived value to the buyer. Hence, you must learn to assess each buyer’s perception of what constitutes value to them before discussing your services. Traditionally, such an assessment is done through the use of astute questioning (e.g., “What is most important to you in selecting an external provider of occupational health services?”). Once you have an understanding of what motivates the prospective buyer, only …
Read MoreCleared for Takeoff
JOHN SHUFELDT, MD, JD, MBA, FACEP I like checklists. I use them while treating patients, flying, cooking, and training. Despite the fact that I have a few thousand hours behind the controls of a variety of aircraft, I still use them every time I fly. Why then, if I believe I am a fairly competent pilot, do I need to rely on something as pedestrian as a checklist for things that I have done countless …
Read MoreCoding for Rectal Strep and Injury Exposure Visits, Billing for Slit Lamp Exams, and a Follow-up on Splinting
DAVID STERN, MD (Practice Velocity) Q. What is the correct ICD-9 code for rectal strep? Question submitted by Cindy Reisbeck, Littleton, CO A. There are several possible codes. The specific ICD-9 code would depend on a more specific diagnosis. For streptococcal infections in the rectal or perirectal area, there are several possible correct codes, as streptococcal species can cause multiple different types of localized conditions. For cellulitis, the correct code would be 566; for erysipelas, …
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