Correct Coding in Your Startup Urgent Care Center

Mistake #7 - Ignoring coding in your startup urgent care center

If you perform services, you should get paid for those services. But if your urgent care doesn't code for it, you will not get paid for it. Coding is the lifeblood of your new urgent care center. Ignore coding and you will hemorrhage potential revenue from your urgent care center. There are scores of significant coding issues with which few physicians are fully familiar. Many of these issues are unique to an urgent care setting. Every day Practice Velocity fields questions about coding from coding experts from around the USA. Their questions make it clear that, as with medical practice, medical coding is a specialized field-requiring specialized knowledge in the specialty at hand. Urgent care is just such a specialty. Unique coding issues to your new urgent care center include:

1. When can you append an evaluation and management (E&M) code to a procedure?
2. What modifiers must be added to an E&M code in order to assure payment?
3. How can you successfully appeal when a payer consistently denies payment for the E&M code in this situation?
4. What is the definition of an established vs. a new patient in urgent care? How and when does it differ from a primary care practice?
   With what payers and in what circumstances do the definitions differ?
5. When can you code for a intermediate laceration repair even if you have not performed a layered repair?
6. How do you code for multiple procedures performed on the same visit?
7. What determines a comprehensive exam under 1995 guidelines and 1997 guidelines?
8. When can you get credit for a complete history even though a complete history was not performed?
9. What is the difference between the CMS definition of body areas and organ systems for E/M coding? At hat levels of physical exam do I count body areas, organ systems, or both?

The CEO of Practice Velocity, Dr. David Stern is a certified professional coder and writes a monthly column in the Journal of Urgent Care Medicine (JUCM). Every month you can read more information about coding issues that are specific to urgent care. We encourage urgent care physicians to go to the JUCM website and sign up for a free subscription to JUCM.

You can spend years studying coding, or you can work with an expert in urgent care coding. Practice Velocity is just such an expert in urgent care coding. We work with our client urgent care centers to make sure that they get paid for everything that they do. Our software and services can help you with the following:

• Automated E/M coding
• Audit trail for each E/M code
• Use 1997 guidelines &/or 1995 guidelines for E/M coding
• Checkbox CLIA-waved test CPT coding
• Automated ICD-9 coding
• Automated modifiers related to global periods
• Automatic code import into Practice Velocity Management billing software

Even better, Practice Velocity customers can pick up the phone and discuss coding issues with the expert coders at Practice Velocity. Contact Practice Velocity today and learn more about Practice Velocity coding solutions for your urgent care center.