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Questions for Dr. Stern

About Your Urgent Care Center

36. We have recently opened our first urgent care and there has been some disagreement on charting.  Is there a location to find documentation on the required charting for an urgent care?  I know the urgent care uses the same E & M codes as a family practice.  Does the same criteria apply to an urgent care as in a family practice i.e.  family history, past medical history, social history, etc?  We have a provider working at the urgent care that comes from an emergency room environment and he is insisting those items aren’t required to substantiate an evaluation and management level of service.  Is that correct?

Thank you for contacting UCAOA. We are excited to see our many members thrive in serving their communities all over the USA.
To answer your question, the same criteria (for e/m coding: 99201 - 99205) apply for an urgent care center and for a family practice. Of course, these criteria are extremely complex and very few providers have a good handle on them. Isn’t it just like the government to set up rules that are so complex that no reasonable person can follow them; and then charge any doctor with fraud who does not follow their rules exactly?
Your provider’s confusion may arise from the ED background of your provider. The criteria for ED e/m codes (99281 99285) do not correlate with the outpatient e/m codes (99201-99215).

 

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David Stern, MD, CPC
CEO, Practice Velocity
Partner, Physicians Immediate Care
Board Member, Urgent Care      Association of America

Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

 

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