Practice Management
Patrick O’Malley, MD; Albert Botchway, PhD; Laurel Stoimenoff, PT (ret.); and Lindsey E. Fish, MD, on behalf of the College of Urgent Care Medicine Over the past 15 years, there have been significant changes in urgent care (UC) medicine. First and foremost, this is a rapidly expanding field of medicine as urgent care centers now provide more than 200 million visits a year performed in more than 14,000 locations. Additionally, urgent care centers have transitioned …
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The percentage of urgent care visits involving a laceration procedure increased slightly from 0.75% in 2023 to 0.76% year-to-date in 2024, which is on-par with 2018 levels, according to Experity EMR analysis of more than 93.8 million urgent care visits, as of October 6, 2024. Over the past 15 years, the percentage of patients presenting with a laceration has gradually declined, attributed to a number of factors—chief among them being “case rate” reimbursement. Case rate …
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Patrick O’Malley, MD Urgent Message: Clinicians can apply best-practice care principles for lacerations of the hand in the urgent care setting by gaining a better understanding of the anatomy and wound repair techniques. Such competency can also help reduce non-indicated referrals to the emergency department. Citation: O’Malley P. Does This Finger Laceration Need Immediate Vascular Surgery Consultation Perspectives Based on an Urgent Care Patient Experience. J Urgent Care Med. 2024;18(4): 28-30 Key words: laceration, …
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Urgent message: Lacerations are a common reason for patients to present to urgent care. Data suggest not all providers are comfortable managing lacerations, however. Clinicians who need additional training should be afforded such in order to reduce acuity degradation and unnecessary referrals to the emergency room. David T. Ford, MD; Patrick M. O’Malley, MD; and Brantley Dick, MD Citation: Ford DT, O’Malley PM, Dick B. Assessing Urgent Care Clinics’ Readiness to manage a lip laceration. …
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Urgent message: Fragile skin lacerations in geriatric patients require a different repair strategy from those in younger patients. Despite the increased complexity of their wounds, most elderly patients with lacerations can be appropriately managed in the urgent care center. Oscar D. Almeida, Jr., MD, FACOG, FACS and Amy Hunter, DNP, FNP-BC, MSN-RN INTRODUCTION Skin tears form a subcategory of traumatic lacerations frequently affecting older adults. A study that searched Medline and Cochrane Reviews found that …
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Urgent message: Adhesive repair for skin lacerations in pediatric patients is a viable (sometimes preferable) option—under the right circumstances. Careful consideration is warranted when the wound is to the chin. Joshua Sherman, MD and David Mathison, MD, MBA INTRODUCTION The use of adhesive repair in lieu of sutures for the management of minor lacerations has become increasingly commonplace.1 When used correctly, cosmetic outcomes are similar and may be superior to suture repair in certain situations. …
Read MoreQ: We had a patient present with multiple lacerations and were wondering how to bill, since some were repaired with sutures and some were repaired with staples. A: Laceration repair is billed based on the complexity, length of the repair, and the anatomic site. The repair can consist of sutures, staples, or wound adhesive (eg, Dermabond). The Current Procedural Terminology (CPT) manual classifies the complexity of the repair of wounds as being simple, intermediate, or …
Read MoreQ. We had a patient present with 12 plantar warts. The provider used liquid nitrogen to freeze all 12 of the warts. What code should I bill for this procedure? A. In this case, you would bill Current Procedural Terminology (CPT) code 17110, “Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.” Use only code 17110 once because the …
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Urgent message: Because typical participants in mixed martial arts are young and healthy, many present to urgent care settings with a clear musculoskeletal injury and no other medical problems. Do not be distracted by the most obvious injury. Injuries from atypical mechanisms of injury are common in mixed martial arts and should be considered when evaluating a patient who has sustained injuries while participating in the sport. DEENA R. ZIMMERMAN, MD, MPH, IBCLC; NAHUM KOVALSKI, …
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