Q.We are in the process of adding urgent care services to our occupational medicine clinic. How do we determine when to use a new or established E/M code for the patients who are seen for urgent care services? A.I continue to receive questions regarding the “when to code new or established patient E&M codes” conundrum, so let’s try to simplify the issue. The official CPT definition of new patient is: A patient who has not …
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Failing to Plan—or Planning To Fail? Designing a Clinic for Success
Urgent message: Making the best use of the space you have is not just a matter of comfort and esthetics; an efficient floor plan contributes to providing proper—and cost-effective—care and services. Patrice Pash, RN, BSN, COHC So you’ve signed the lease or purchased the property and you’re sitting there staring at this huge empty shell, dreaming of the potential finished space. What will it look like? How many exam rooms do you need? What additional …
Read MoreDeveloping Data: December, 2008
In early 2008, UCA revamped its annual survey in conjunction with researchers at Massachusetts General Hospital and Harvard University with the goal of assuring that the UCA Benchmarking Committee’s efforts produced a scientifically valid report. Over the coming months in Developing Data, JUCM will present some of the findings from this landmark survey, to which 436 urgent care centers responded. In this issue: How much money do physicians who work in urgent care centers make? …
Read MoreCoding Symptoms of Infections, Modifiers for X-rays, and Counseling Family Members
DAVID STERN, MD (Practice Velocity) Q.Our doctor saw a patient for a sore throat. The rapid strep screen was positive, so she placed the following diagnoses on the chart: 0: Streptococcal sore throat 61: Fever presenting with conditions classi- fied elsewhere 1: Throat pain 79: Other malaise and fatigue I told her that since we had a specific infection that was the cause of second, third, and fourth diagnoses, we should code the confirmed infection, …
Read MoreThe Herd Mentality and Occupational Health Sales
The Merriam-Webster dictionary defines herd as “a group of individuals usually having a common bond” or “a number of animals kept under some type of human control.” So let us think bulls (to some, a fitting metaphor for a piece on sales). For every early adaptor or contrarian, there seem to be 10 other people who prefer to follow the leader. For every buyer of urgent care occupational health services who buys offensively out of …
Read MoreStrategies on Responding to Variable Patient Acuity and Flow
JOHN SHUFELDT, MD, JD, MBA, FACEP Over the years, I have worked with a variety of providers who exhibited significantly disparate skill levels in their ability to manage patient flow. Practicing good medicine is a given; some have been amazingly intelligent providers who make House look like a PG1 psychiatry resident from a non-accredited medical school. Their only downside was that they were pathetically slow, or communicated at the level of a mollusk. Effective and …
Read MoreDeveloping Data: November, 2008
In early 2008, UCA revamped its annual survey in conjunction with researchers at Massachusetts General Hospital and Harvard University with the goal of assuring that the UCA Benchmarking Committee’s efforts produced a scientifically valid report. Over the coming months in Developing Data, JUCM will present some of the findings from this landmark survey, to which 436 urgent care centers responded. In this issue: How large are urgent care centers? It is important to note that …
Read MoreICD-9 Changes in 2008
DAVID STERN, MD (Practice Velocity) Q.I noticed that I am getting rejections for the code for fever (780.6). Do I need to add another diagnosis code to get paid? A.There are numerous separate issues related to this code: First, every year ICD-9 updates go into effect on Octo- ber This year was no exception. This code is now sub- categorized as follows: 60 Fever, unspecified 61 Fever presenting with conditions classified elsewhere 62 Postprocedural fever …
Read MoreManaging Through Change
JOHN SHUFELDT, MD, JD, MBA, FACEP The urgent care sector in particular, and healthcare in general, is undergoing a sea change—a phrase that has its origins in Shakespeare’s The Tempest: Full fathom five thy father lies Of his bones are coral made Those are pearls that were his eyes Nothing of him that doth fade But doth suffer a sea-change Into something rich and strange. Shakespeare was referring to the corpse of Ferdinand’s father being …
Read MoreHedging Your Bets: The Art of Market Segmentation
If you have more than one child or grew up with at least one sibling, you have probably experienced “segmentation.” That is, you have most likely used different tactics and strategies in dealing with each of your children or you were treated somewhat differently than your siblings. Segmentation within the urgent care occupational health market follows the same principle; a communication technique that is effective with one audience may not work as well with another. …
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