01/05/2015    Gregory T. Amarantos, DPM

We Are Physicians, Not Pedicurists! (Robert Kornfeld, DPM)

Both Drs. Kornfeld and Kanakiadis present valid
perspectives regarding the FRAUD that is being
committed by many of our colleagues and nurse
practitioners. I am glad I never chose to play the
"game". If it is a covered service, I bill it, if
it is not a covered service, the patient is
responsible. Remember, a non-covered service is
not subject to limiting charges by Medicare or
other insurers. For the past 31 years, as long as
I have been practicing, the same issues have
presented themselves with no apparent solution.

Those who choose to practice in the murky waters
of the CPT code book can continue to do so. In
the future we will be subject to continued reduced
reimbursement and you will soon find you are
working for peanuts and have prostituted
yourselves. I for one, tell the patient it is not
a covered service and I get paid the fee I ask.
This can include non-covered Medicare services,
PRP injections, shockwave therapy or even trimming
calluses on patients with private insurance.

I have a radical idea. If the services provided
are covered, there should be nothing to hide.
Therefore, mandate all routine foot care or "at
risk foot-care" (the new politically popular
phrase to describe trimming calluses and nails on
otherwise healthy patients) to be photographed and
the photo should be signed by the provider and the
patient. Likewise, the patients with pvd would
need documentation with an arterial Doppler. Just
think of how quickly the fraud would stop. With
the money Medicare saves, the fee schedules for
the covered services could be increased to
compensate the physician for the added hassles of
documentation.

There are always those who try to scam the system.
A zebra cannot change its' spots. We know who they
are. If they have no shame, there is nothing
anybody can do to change their modus operandi.
In the meantime, this discussion will probably
continue for the next 31 years or until Medicare
radically changes the policy and punishes those
who follow the rules because of the few who
perpetuate the fraud.

Gregory T. Amarantos, DPM, Chicago, IL

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