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PM News

The Voice of Podiatrists

Serving Over 18,401 Subscribers Daily


November 07, 2018 #6,303 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

palmay1418

PM NEWS QUICK POLL

Quick Poll

 
Have you ever conducted a patient satisfaction survey?
 
pedifixmar518

APMA NEWS
APMA Launches Diabetes Campaign 
 
The American Podiatric Medical Association (APMA) has announced its Today's Podiatrist diabetes campaign, which will educate the public about diabetes and its complications in the feet, as well as the value of a podiatrist in preventing and managing those complications.
 
Dr. Dennis Frisch
 
"Today's Podiatrist is a critical member of the diabetes care team," said APMA President Dennis Frisch, DPM. "Feet can be a direct reflection of overall health. Conducting daily foot exams at home and seeing a podiatrist for a full exam at least once a year are vital steps to managing your diabetes."
 
Source: Market Insider [11/1/18]
richieoct118

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.
 
Today's Featured Article
 
BakoNov518B

PRACTICE MANAGEMENT TIP OF THE DAY
Convincing Patients to Respond to Surveys is Easier Than You Think - Part 3
 
You might be surprised to learn that 86 percent of Americans say they would likely take a survey from a healthcare provider, if asked. A West survey of 1,036 adults in the United States showed patients are more open to taking surveys than most providers realize. The following recommendations, based on West’s survey findings, show three key ways healthcare teams can grow response rates by focusing on factors patients say influence their decision to participate in surveys. The following recommendations, based on West’s survey findings, show three key ways healthcare teams can grow response rates by focusing on factors patients say influence their decision to participate in surveys.
 
3. Follow through on follow-up. Actions speak louder than words. Rather than just telling patients about the benefits or how surveys can help them, healthcare teams can go a step further and show patients with follow-up communication. Patients who spend time completing a survey want to hear from their healthcare team. Thirty-four percent of patients say they would be more likely to take a survey if they were contacted immediately afterward by a healthcare provider. In addition, patients say providers who follow up over the phone (37 percent) or via a text message or online chat (32 percent) would entice them to take surveys. While immediate follow-up is not necessary or appropriate in every situation, healthcare teams can make sure patients understand that they will be contacted promptly if follow-up is warranted.
 
Source: Allison Hart, Physicians Practice [10/29/18]
ohioct818A

CODINGLINE CORNER
Query: Gouty Tophi Debridement
 
I debrided gouty tophi to the level of medullary bone, removed a retained screw at the first metatarsal, and smoothed rough edges of an arthritic first metatarsal phalangeal joint using rongeur, then closed the wound primarily. For diagnoses, I am using M19.272 (secondary arthritis left foot), M1A.0721 (idiopathic chronic gout, left foot, with tophi), and T84.6 (infection and inflammatory reaction due to internal fixation device). I am looking for advice regarding proper CPT code(s) for this procedure.
 
Troy Harris, DPM, Swansboro, NC
 
Response: I suggest CPT code 28041 for excision of gouty tophus and for the screw removal CPT code 20680 along with removal of any bone from the 1st MPTJ, and then I would use CPT codes 28126 for the phalanx and CPT 28111 for the metatarsal bony removal, respectively.
 
Joseph Borreggine, DPM, Charleston, IL
 
For information on Codingline subscriptions, click here
MDBuyinggroupAug2018

QUERIES (NON-CLINICAL)
Query: Dealing with Specialists Who Don't Send Referral Letters
 
For many years. I referred my patients presenting with peripheral vascular disease to a very prominent and respected vascular specialist in my area. He was not only an excellent diagnostician and surgeon, but always sent me timely reports on the management of our mutual patients. Unfortunately, this doctor passed on and all of his patients were turned over to an equally prominent vascular specialist. The only problem is that this new specialist does not send reports nor does he return phone calls.
 
This past month, one of my patients with recurring ischemic ulcers went back to this doctor at my request. Not only did he not sent me a report, but he did not return phone calls to either me or the patient and the only line of communication is when the patient actually sees him in his practice.
 
PVD has legal exposure, especially if the patient's condition worsens and s(he) needs an amputation. With no reports or any return phone calls, I am the one who will be left standing without a leg if the patient should decide to sue. Needless to say, I do not refer any new patients to this doctor, but the ones who are already using him have no intention of changing. Our insurance companies warn us to have documentations from specialists but how do we as podiatrists handle cases when a specialist does not believe in sending reports?
 
Elliot Udell, DPM, Hicksville, NY
blaineoct2918

RESPONSES/COMMENTS (BILLING AND CODING)
RE: Fraudulent Billing of CPT 28555 
From: Name Withheld
 
After discussions with billing experts, podiatric surgeons, and orthopedic foot and ankle surgeons, and reviewing the CPT descriptors for the following codes, here are my comments: If you are billing the code 28555 (open treatment of a tarsal bone dislocation, includes internal fixation), when performed and you are performing an arthroreisis procedure, you have committed fraud. Period. 
 
If you are billing 28585 (open treatment of a talotarsal dislocation, includes internal fixation), when performed and you are performing an arthroereisis procedure, you have committed fraud. Period. If you are billing 28725, Arthodesis, subtalar and you are performing an athroereisis, you have committed fraud. Period.  
 
The owners or manufacturers or sales people can tell you anything they want. None of the procedures mentioned above are appropriate when you are performing an arthroereisis. If you’ve gotten paid in the past for the above when using an arthroereisis, consider yourself lucky that you haven’t been caught...yet. These codes are incredibly abused and are NOT applicable when performing an athroereisis. 
 
Name Withheld 
orthonov518

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1
From: Cynthia S. Ferrelli, DPM
 
I really don’t see how we can afford to do multiple procedures and still stay in business. I only do one procedure at a time. For instance, when performing a matrixectomy, I tell the patient that we need to see how the area heals, how they react to the anesthesia and phenol, how they heal before I will perform this on another toe. Most patients accept that without issue. If they don’t come back for the other toe, I don’t feel like I have lost out, because another patient needing the procedure is right behind them. We don't not get paid enough as it is for procedures; therefore, I am not willing to accept 50% for an additional procedure.
 
Cynthia S. Ferrelli, DPM, Buffalo, NY
NWPLjul218

RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Vincent Marino, DPM
 
I have been treating Workers Compensation patients as well as performing medical legal evaluations on them for the past 25 years in California. However, the federal government Workers Compensation laws (for which a postal worker falls under) are quite different than any of the state laws. What you need to determine is whether or not the occupation of this postal worker acts as an aggravating factor rather than as an exacerbating factor.
 
In other words, does the employment simply temporarily increase the symptoms or does the employment increase the symptoms requiring further treatments and accommodations? If it is the latter, then it is considered an industrial injury. In your case, most likely your patient will have a legitimate industrial injury since weight-bearing is such a large part of their job requirements - regardless of weight, pronation, equinus, etc. Even for these to be the CAUSES, the person needs to be weight-bearing. I hope this helps explain the issues.
 
Vincent Marino, DPM, San Francisco, CA
realmoct1518

RESPONSES/COMMENTS (EMR) - PART 1A
From: Michaele A. Crawford, DPM
 
I have been using NextGen for 3 years. I honestly cannot recommend them. Although they claim to be the #1 program, we have found that the reports are difficult to understand and locate, their auto-post component was posting incorrectly and writing off patient amounts, and their tutorials are outdated. It requires multiple clicks to get to different areas of the patient note, and you cannot access the note and the scheduler at the same time. My staff has to keep 2 windows open, one with the “dashboard” where you create the notes and another with the “Practice Management tab” to do the scheduling. The initial setup was painful, as I’m sure it is with many. They imported all of my data from my prior program, but much of the data is flawed and I am having to pay a monthly rate to the prior company to access that data. It does have all of the components necessary to report for MIPS. That portion of the system was fairly easy to understand. 
 
I switched to them from TRAKnet. I left TRAKnet because there was no communication, initially, that they were going to be compliant with the PQRS requirements. I wish I had never left them. The program had a fast learning curve, and setup was easy as they allow access to other podiatrists note templates, which you could download and modify to your liking. Reports were easy to locate and read.
 
Michaele A. Crawford, DPM, Butler, PA
Danipro

RESPONSES/COMMENTS (EMR) - PART 1B
From: Brian Kiel, DPM, Jeff Frederick, DPM
 
We were bought by a multi-specialty group 14 months ago and had to go to NextGen from McKesson. This EMR (NextGen) is much more complete and gives much more information. It does take a lot of clicks at times, but it is possible to make templates and customize many of the entries. I am satisfied with it. 
 
Brian Kiel, DPM, Memphis, TN
 
TRAKnet is the only EHR that is owned and operated by podiatrists for podiatrists. The EHR is totally podiatry-centric and the most used EHR by podiatrists who use electronic health records.  
 
Disclosure: TrakNet is a product of Nemo  Health 
 
Jeff Frederick, DPM, Executive VP, NEMO Health
sigma

YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoe of the Day

What a meshy shoe!

Source: Pauline van Dongen via Virtual Shoe Museum

Diabetic Limb Salvage Fellowship

Two positions for a 12-month Diabetic Limb Salvage fellowship beginning July 1, 2019. Candidates must complete a podiatry residency by June 30, 2019 and be eligible for a Texas Podiatric Medical License. Training involves all aspect of diabetic foot management. Curriculum focuses on surgical limb salvage, and medical management of the complex, high-risk diabetic patients at risk for limb loss.  Interested candidates should email their CV, personal statement and three (3) letters of recommendation to Tomeka.bennett@utsouthwestern.edu  UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.


MEETING NOTICES

presentnov518A

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Choose any or ALL from 25+ CECH Category-1 articles posted


CLASSIFIED ADS PART 1 - ASSOCIATE POSITIONS AND FELLOWSHIPS
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 podiatristsmd@gmail.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
 
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 podiatryoffer@gmail.com
 
ASSOCIATE POSITION - UPSTATE NY 
 
Excellent opportunity to start your career in a fresh practice! Seeking an associate to join, grow, and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Looking for a motivated individual to contribute to our growth through all aspects of podiatry. Please send CV to: docryanlee@gmail.com
 
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: dysteindpm@gmail.com
 
ASSOCIATE POSITIONS – PHOENIX 
 
Phoenix office seeking the services of podiatrists. Practice offers a great opportunity to the right physicians to establish and grow. Physicians holding an Arizona State license preferred. IMMEDIATE full and part-time openings available. Please email your CV and cover letter to FootAnkleRescue@gmail.com
 
ASSOCIATE PODIATRIST NEEDED ASAP (AND JULY 2019) 
 
Looking for enthusiastic, industrious podiatrist to join Foot and Ankle Specialists of the Mid-Atlantic practice in Wheaton and Rockville/ Shady Grove, Maryland. Surgical boards and ties to Maryland preferred. Good benefits and a competitive base salary with incentives. The position is available immediately but I am also interested in hiring another in July 2019. If you are interested in this opportunity, please respond to me (aspector@footandankle-usa.com) with your resume, comments and questions. I look forward to hearing from you. Adam K. Spector DPM, FASPS, Partner, Foot and Ankle Specialists of the Mid-Atlantic, Wheaton/Shady Grove Division,  (301-949-3668), aspector@footandankle-usa.com
 
ASSOCIATE POSITION - WASHINGTON, DC 
 
Growing, well-established practice seeking well-trained, hard-working surgical trained podiatrist. Practice with concentration in foot & ankle surgery as well as sports medicine. Excellent referral base. Downtown location. Full benefits package. Please send CV to WDCDPM@gmail.com
 
ASSOCIATE POSITION - UPSTATE SOUTH CAROLINA
 
Busy two physician practice in Upstate South Carolina seeking highly motivated, ethical associate. PSR-36 trained. High surgery case load. Competitive benefits & salary. Send CV to upstatescpodiatry@gmail.com
 
ASSOCIATE POSITION - MONTEREY BAY, CALIFORNIA 
 
Work in beautiful Monterey Bay where the weather is wonderful. ASK Medical group is seeking a personable and energetic DPM to work in our long-term care clinic. Excellent income potential with discretionary time. Come and work with a professionally managed team (over 100 years’ experience). We also have a position available in Shasta County, Northern CA. Please send CV and interest letter to dwayne8543@gmail.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: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com  or call (215) 808-0770.
CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
SPACE AVAILABLE – NY AND LONG ISLAND
 
Offices available to sublet and share, Manhattan and North Shore Long Island. Offices fully equipped with state-of-the-art equipment extremity MRI, foot/ankle CT scanner, diagnostic ultrasound and the availability to become a staff member of a certified ambulatory surgical center. Call 1516 476-1815 podo2345@aol.com 
 
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 blmpodiatry@gmail.com
 
PRACTICE FOR SALE - WESTERN WASHINGTON 
 
30 year established practice in Auburn Washington. In medical office building connected to hospital. Practice scope includes clinic, hospital-based surgery, and hospital consultations. Forefoot, rearfoot, and ankle surgery. Will stay on three months during transition. Contact/send resume to Dgusman@hotmail.com
 
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: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com  or call (215) 808-0770.
Disclaimers
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.
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Barry H. Block, DPM, JD
 
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