From "A Chance to Cut is a Chance to Cure" This note about sending patients to the ER.
In primary care .. it's not so clear as in general surgery.
Yesterday I met a patient at the office (yep — Saturday afternoon) who called with "doc I feel just rotten." It would not have been appropraite to send him to the ER … and some may have had him take some tylenol and come to the office Monday AM. ..
when I saw him, I was glad that I did what I did.
Temperature was 103. Exam revealed cellulitis of the right leg ("well, my leg did hurt some") and a blood sugar of 156.
(no known medical problems, by-the-way)
So now you know the diagnosis.
While I doubt anyone would argue that this would have been an abuse of an ER .. I think that most would agree that cellulitis and a new diagnosis of type 2 diabetes is more appropriately managed in the primary physician's office — where follow-up can be arranged (he's doing much better today) and continuity is maintained.
How to bill?
99050 (rarely paid .. but we'll ask the insurer for it anyway)
