November 22, 2018 #6,314 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2018- No part of PM News can be reproduced without the written permission of Barry Block
We wish all our readers and families a Happy Thanksgiving
PM NEWS QUICK POLL
What is your outlook for podiatry in the next 5 years?
PODIATRISTS IN THE COMMUNITY - PART 1
OH Podiatrist Donates $19,700 to Diabetes Partnership
As an effort to combat diabetes and support local diabetics and their caregivers, Ankle & Foot Care Centers hosts an annual golf benefit fundraiser and the proceeds go toward the Diabetes Partnership of the Mahoning Valley (DPMV). This year’s event raised $19,707 for the organization. Since 1999, Ankle & Foot Care Centers has raised nearly $185,000 from the golf outing and has donated funds to the American Diabetes Association up until four years ago, and then it began donating the funds to the DPMV, totaling nearly $80,000.
Dr. Michelle Anania (Center) with DPMV co-founders Ed and Marg Hassay
“The purpose for the annual golf benefit has always been to raise funds for diabetic support and research,” said Dr. Michelle Anania, the Ankle & Foot physician who leads the golf benefit and works closely with the partnership. “But, about four years ago, we began supporting the DPMV because we know 100 percent of the proceeds stay here in the Valley and goes toward supporting individuals with diabetes.”
PODIATRISTS IN THE COMMUNITY - PART 2
AZ Podiatrist Joins Santa Cruz Valley Regional Hospital
The Santa Cruz Valley Regional Hospital has added its first on-site podiatrist to their team. Steven M. Gillespie, DPM will start treating patients at the hospital on Nov. 26.
Dr. Steven Gillespie
Dr. Gillespie graduated from Des Moines University - College of Podiatric Medicine and completed a residency at the U.S. Department of Veterans Affairs. He currently practices at Southern Arizona VA Health Care System and is affiliated with Oro Valley Hospital.
Source: KVOA News 4 (NBC) [11/20/18]
ON THE INTERNATIONAL LECTURE CIRCUIT
IL Podiatrist Speaks at Madrid Conference
The D-Foot International Implementation Summit is held every four years to review and implement new guidelines in the treatment of the diabetic foot worldwide. Representatives from over 120 countries are asked to participate in this conference and there were 180 in attendance. APMA past president Matthew Garoufalis, DPM attended the conference, representing the International Federation of Podiatrists (FIP) as immediate past president as well as lending support to the representatives from the American Board of Podiatric Medicine who were in attendance also.
Dr. Matthew Garoufalis
Dr. Garoufalis gave a presentation on “Building a Platform for Podiatry in Europe for the European Union" that could be used to expand podiatry around the world. He also spoke about the just published "POINT" Project paper (Podiatric Skills for International Diabetic Foot Teams), of which he is a co-author. This paper is a supplement in the current issue of the Journal of Wound Care.
FROM PM's CURRENT ISSUE
Several times a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
Another burden that payers distribute is the authorization process. It costs the practice more to do business with a payer who needs an authorization for seemingly everything. Unless a payer can prove that my practice has much higher utilization of a procedure or test than our peers, I fight to make the authorization go away since the authorization process’s only result is costing us more money.
Source: Lucien Roberts, Physicians Practice [11/7/18]
Query: Diabetic Shoe Documentation
1) Would a qualifying diagnosis code that is included in a certifying physician’s encounter indicating risk factors, but no written description of foot pathology, fulfill requirements for diabetic shoes? Would this pass an audit? 2) Would an unspecific code (M21.969 [Unspecified acquired deformity of unspecified lower leg]) be acceptable in the certifying physician’s note?
Jeffrie Leibovitz, DPM, Indianapolis, IN
Response: 1) The auditor will basically be reviewing your notes for the local foot findings to see if they are supportive of what findings are required by the LCD. The auditor will then review the MD/DO note to see if it supports the coverage parameters for DM. It has been my experience (and I have been told this by the DME reviewers) that the MD/DO’s notes of foot findings are not as important, so long as the MD/DO signs a statement that they agree/attest and/or support your findings. That is your note as the foot specialist will trump that of the MD/DO who is treating the DM. But your note, on its own, without that of the MD/DO who is treating the DM will not pass an audit.
2) This is more problematic. I always suggest that you stay away from the unspecified codes simply because Medicare and ICD-10 demand you code to the highest level of specificity. If you must use an unspecified code, be sure you can link that diagnosis to DM.
Paul Kesselman, DPM, Woodside, NY
For information on Codingline subscriptions, click here
There was a recent query and follow-up printed regarding CPT code 64450. The code is essentially a diagnostic nerve block. Diagnostic nerve blocks are often used to help gain insight into a proper diagnosis. The code is no longer a valid code. (And is not the proper code for treatment of neurons or fasciitis as previously stated). The real question is why was this important code eliminated? And, what if anything did the podiatric community do to prevent its elimination? A follow-up question is how does one code a diagnostic nerve block now? Has this become an uncovered service?
Dr. Gurnick’s suggestions are spot on. Biomechanics is an intra-tester and not an inter-tester science. The lack of high level applicable evidence proves that. Limb length correction of balance and asymmetry at the level of the foot in closed chain is a vital service podiatry takes the lead on. In suggesting that our colleagues should “be checking for LLD” as an approach that is “quite understandable to our patients”, my comment is that there is currently no consensus for doing that.
Over the years. I have developed a protocol for doing just what Dr. Gurnick has ordered. I call LLD “The Inclined Posture or TIP”. Patients understand this terminology and it is kinder to be called tipped than lopsided. I published on this subject in 2016. The important caveat is that about 10% of the time, TIP testing is reversed due to a primary problem in the spine such as scoliosis. In these cases, the bigger bunion and larger foot is often on the short side. Once mastered intra-tester, this program works better than any other in existence.
Dennis Shavelson, DPM, NY, NY
YOU CAN'T MAKE THESE THINGS UP
RE: Outrageous Shoe of the Day
What to wear to Thanksgiving dinner?
NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MD, MI, MI, MS, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, VT, WV, WI, & WY
Partial required credits can be taken online for AZ, CT, FL, GA, ID, KY, IL, ID, IA, MN, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, WA, and DC
Choose any or ALLfrom 25+ CECHCategory-1 articles posted
CLASSIFIED ADS PART1 - ASSOCIATE POSITIONS AND FELLOWSHIPS
ASSOCIATE WANTED– NEW JERSEY
Looking for full-time podiatry associate in East Orange, NJ. Associated with Wound Center. Competitive Salary and benefits. Looking for someone interested in long term arrangement, with buy in option in 2 years. Send CV and cover letter to email@example.com
ASSOCIATE POSITIONS – FLORIDA
A provider of high quality podiatric care in nursing facilities is looking for podiatrists to treat patients in Florida. We are a fast growing company looking for motivated, caring podiatrists. Full-time and part-time positions available. Please send your CV & cover letter to firstname.lastname@example.org.
ASSOCIATE POSITION - VICTORIA, BRITISH COLUMBIA
Retiring Soon. Looking for associate to join busy practice in beautiful Victoria, British Columbia
Candidate must have completed residency. Will sponsor for immigration For terms email email@example.com
ASSOCIATE POSITION – NORTH CAROLINA
Great opportunity in rural Northeastern NC! 20 year, well established practice with multiple locations, ready to continue to grow, seeking hard working podiatrist/s just entering practice or with experience, to join us. North Carolina license a must, Send questions and/or CV to firstname.lastname@example.org
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA
PSR 24-36 Trained Multi-dimensional, Multi-office group treating a wide range of patients to include: forefoot, rearfoot, diabetic wound care, sports medicine and work-related injuries. A great opportunity for driven personable individual. Please e-mail CV, Letter of references, 1 minute Video Introduction Email: email@example.com
ASSOCIATE POSITION - LOS ANGELES CA
Excellent opportunity for hard working, ethical rearfoot and ankle trained foot & ankle surgeon. Full scope practice including fore/rearfoot surgery, trauma, biomechanics. Located across the street from a major hospital. Associateship leading to partnership. Email CV to firstname.lastname@example.org
ASSOCIATE POSITION- EL PASO, TX
If your passion is to enhance people's independence and quality of life through helping them improve their mobility, then a career as a Preferred Podiatry Group podiatrist could be for you. Flexibility, autonomy, resources - they're all yours! Oh, and did we mention that there's very high earning potential based on patient volume? Please send an email to recruiting@PPGpc.com if you're interested in learning more about PPG podiatric care for residents in long term care homes.
ASSOCIATE POSITION– MARYLAND
Established practice looking for a full-time podiatrist for our three Maryland locations. The ideal candidate will have strong clinical skills including ulcer care, diabetes, surgery and general foot care. Must have a strong office personality with the ability to maintain and attract patients. Must be willing to merge into an already established protocol based office. Please send C/V to email@example.com
ASSOCIATE POSITION - NASSAU COUNTY, NY
Exciting opportunity! Busy Nassau County, NY office seeks full time podiatrist. State-of-the-art facility. Complete EMR, digital radiograph and diagnostic ultrasound. Excellent salary and benefits. Must be board qualified. Please e-mail resume to: Medicalofficeinquiry@gmail.com, or call: 516-902-1073
ASSOCIATE POSITION – HOUSTON, TEXAS
Busy podiatry practice seeks motivated DPM to join our team. Amazing opportunity for someone looking to grow with us. Incredible company culture. Suburban outpatient practice in an active part of town. Sports medicine and lots of kids. No weekends or hospital call. Interested applicants invited to send CV's to: HoustonDPMJob@gmail.com
ASSOCIATE POSITION- ORANGE COUNTY, CA
Busy practice looking for a bilingual, Spanish speaking, part or full-time associate for a multi-office practice. Both Non-surgical & PSR-24-36 Board qualified/certified foot and ankle physicians and/or fellowship trained surgeons wanted. Candidate must be personable, outgoing and motivated with excellent bedside manner with ability to be busy from day one. Must be competent in all areas of conservative, wound care and surgical treatments of the foot and ankle. Competitive salary offered. Email CV to: firstname.lastname@example.org
ASSOCIATE POSITION - LOUISVILLE, KY
Immediate opportunity to walk into a busy three doctor practice to take over for an established podiatrist moving back to his home town for family reasons. Multifaceted well-equipped office centrally located with a local residency. Send resume and letter of interest to email@example.com.
MULTI-LOCATION GROUP- CHICAGO/NEAR WEST SUBURBS
Seeking F.T. ABFAS Board Certified/Eligible associate- P.T. available. MINIMUM 2 year practice experience required. Surgical/ortho patients. Great staff. DME, MIS, EMR, ultrasound, PRP, shockwave, digital x-ray, laser, sx center & Physical Therapy- Top pay, associateship & practice equity available for experienced candidates. Contact firstname.lastname@example.org
ASSOCIATE POSITION – WESTERN PA
Well-established podiatry practice in Western, PA looking for a full-time Podiatrist to join their team. Position will involve seeing patients at multiple hospitals, wound care centers and satellite offices. Basic qualification: Graduation from an accredited medical school and completed accredited residency program. Board Certified/Qualified. Certificate/license medical license to practice in State of Pennsylvania. We offer a competitive compensation and benefits package to our team members. email CV to: email@example.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,500 subscribers. For details, click here or write to: firstname.lastname@example.org or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at email@example.com or call (215) 808-0770.
CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
PRACTICE FOR SALE– BLOOMINGTON, IN
A well-established, profitable 47 year-old podiatry practice is for sale in Bloomington, Indiana. All office equipment and inventory is separately for sale, including but not limited to a digital x-ray, c-arm, laser, and power chairs. Inquires can be made to firstname.lastname@example.org
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details, click here or write to: email@example.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at firstname.lastname@example.org or call (215) 808-0770
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.