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PM News

The Voice of Podiatrists

Serving Over 18,430 Subscribers Daily


September 29, 2020 #6,777 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2020- No part of PM News can be reproduced without the
written permission of Barry Block

ANNUAL SURVEY NOW ONLINE - WIN VALUABLE PRIZES
LAST WEEK TO ENTER & VOTE FOR HALL OF FAME INDUCTEES
 
Congratulations to David Alper, DPM of Belmont, MA winner of last week's prize of a $500 donated by Dr. Robert Smith. We encourage you to participate in this year's important annual survey. Completing this anonymous survey provides us with valuable data, which we will publish in the February 2021 issue of Podiatry ManagementIt also makes you eligible to win thousands of dollars worth of valuable prizes. Enter by completing this confidential survey and providing your e-mail address in the comments section on the last page of the survey. The earlier you enter, the more chances you have to win. NOTEWe are only requesting Information from 2019 (Pre-COVID-19) .
 
How to Win Medicare Appeals
 
 
***This is also your last opportunity to vote for the next DPM and non-DPM inductees into the PM Podiatry Hall of Fame.
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ANKLE SURGERY IN THE NEWS
Total Ankle Arthroplasty Achieves Stable Ankle Platform in Stage 4 Flatfoot
 
In discussing total ankle arthroplasty performed to treat stage 4 flatfoot deformity, Mark E. Easley, MD, an associate professor of orthopedic surgery at Duke University Medical Center said results depend on creating a stable platform for the ankle and the occasional need for soft tissue balancing. 
 
Dr. Mark Easley
 
At the virtual American Orthopaedic Foot & Ankle Society Annual Meeting, Easley likened gap balancing during total ankle arthroplasty (TAA) for post-traumatic or adult acquired flatfoot to the steps used during gap balancing for total knee arthroplasty, both of which call for minimized bone resection, performing a lateral release, or a lateral gutter release in the case of TAA, and no tightening of the medial side of the joint.
 
Source: Susan M. Rapp, healio.com [9/25/20]
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PODIATRISTS AND SPORTS MEDICINE
CT Podiatrist Cites Common Causes of Achilles Tendonitis
 
According to Robert Weiss, DPM, “With Achilles tendonitis, there is usually abnormal motion of the foot and much inward rolling. This causes pain, and muscles and tendons of the Achilles tendon to spasm as it tries to balance the foot. As a result, the tendon becomes inflamed from the torque of the imbalance.“
 
Dr. Robert Weiss
 
"Some causative factors may include: 1) Running on flats instead of mixing the motion with some hills 2) Wearing shoes that cause the Achilles tendon to overstretch 3) Using a shoe with too much cushioning and not enough stability 4) Increasing your mileage log too quickly 5) Running on softer surfaces rather than hard surfaces 6) Worn shoes needing to be replaced and 7) Lack of stretching tight muscles from running," says Dr. Weiss.
 
Source: Darien Times [9/25/20]
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PODIATRISTS AND FOOTWEAR
NY Podiatrist Provides Boot-Buying Tips 
 
The words "podiatrist-approved" and "cute" are oxymorons, so I asked a podiatrist how to keep my feet safe and my footwear functional. Of utmost importance is heel height, says Yolanda Ragland, DPM, a New York City-based podiatrist, foot surgeon, and founder of FixYourFeet.com. "Wearing a completely flat boot is not good for the foot because it can cause plantar fasciitis and provides no support for the arch," says Dr. Ragland.
 
Dr. Yolanda Ragland
 
"Wearing a boot with a heel that is too high is not good because you can wind up getting pain in the ball of the foot—you’re increasing your chances of ankle sprains and plain-old stress in the foot in general." You'll also want to consider taking this personalized approach with respect to a shoe's support. "If you have a high-arched foot, look for a boot with a high arch, or add inserts," Dr. Ragland suggests. "If you have a low arch, make sure the arch of the boot is not too high.”
 
Source: Erin Bunch, MSN Lifestyle [9/25/20]
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INTERNATIONAL PODIATRISTS IN THE COMMUNITY
UK Podiatrist Has Unique Freshwater Swimming Pool
 
Sophie Gooley is a podiatrist who lives near Chichester, West Sussex, with her author husband Tristan and their sons Ben, 16, and Vinnie, 13. "We’ve lived in our old cottage for 13 years and had the pool installed in the one-acre garden five years ago. But rather than your average swimming pool, we wanted it to evoke our fondness for swimming outdoors in the sea and rivers as a family."
 
Sophie Gooley (Photo: Murray Sanders)
 
“People get very confused by our freshwater pool with its reeds and lily pads, querying whether it’s a pond or a swimming pool. It’s very much the latter — but, I will admit, it’s far from traditional. It’s not just a summertime play-thing, either. We use it year-round for swimming, and have even enjoyed a quick dip on Christmas Day,” says Gooley.
 
Source: Daily Mail [9/25/20]
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RELEVANT RESEARCH
Ankle Fracture as a Predictor of Osteoporosis
 
Evidence indicates that ankle fractures are becoming increasingly more common among older people, presenting a significant burden to the U.S. healthcare system, with annual costs exceeding $17 billion for osteoporosis-related fractures, explains Eric So, DPM. “The injury pattern can be quite complex due to the poor bone quality—a proven risk factor for surgical failure and post=operative complications—and strength,” he says. “Assessing bone mineral density in elderly patients who suffer ankle fractures can be an important consideration in the perioperative management of an ankle fracture.”
 
With inconsistent findings from prior research regarding the relationship between ankle fractures and osteoporosis, Dr. So and colleagues conducted a systematic review and met-analysis of observational, cross-sectional studies of high methodological quality in order to quantify the relationship between BMD in elderly patients with ankle fractures compared with that of cohorts without ankle fractures. In the final meta-analysis, seven studies were included that measured BMD using dual-energy x-ray absorptiometry. In all seven, post-menopausal women, women older than 50, or patients with a history of fragility fracture of the ankle were compared with a control group of women older than 50 or healthy post-menopausal women without a history of fragility ankle fractures. Among more than 25,000 patients, the average age was approximately 65.
 
Source: Physician's Weekly [9/26/20]
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PRACTICE MANAGEMENT TIP OF THE DAY
Tips for Treating Deaf Patients - Part 4
 
September is Deaf Awareness Month, these tips will help patients who are deaf have better medical experiences.
 
4. . Lip reading
  • It is important to recognize that not all deaf patients can read lips; even the best lip readers will only pick up about 30% of what is said. When speaking, try not to block your mouth with papers, computers, or your hands.
  • Facial hair can also make it more difficult to lip read. While you don't have to over pronounce or enunciate words, speaking slower can help.
Source: Christine Marshall, MD, MBA, Physicians Practice [9/15/20]
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MEDICAL-LEGAL TIP OF THE DAY
Presenting Your Medicare Case to the ALJ- Part 2
 
4. How should you address the judge? You always address the judge as “Your Honor.” 
 
5. Do you need an outline for the hearing? Yes. When you start writing the outline for your hearing, it will consist of short paragraphs for each topic/part of the hearing. As you rehearse your presentation in front of a mirror, you will reduce the outline from a paragraph for each topic, to a sentence for each topic, to a phrase or word for each topic. When the hearing outline is finished and the rehearsals are completed, the entire outline should fit on one side of one page, with each topic in large print—starting with the beginning topic at the top of the page and the ending topic at the bottom of the page.
 
6. What will you do with the hearing outline? During the hearing, you will check off each topic as the topic is covered. When the judge interrupts your presentation with a question, you will leave the outline and answer whatever questions the judge has. When the judge allows you to return to your presentation, you will return to the last unchecked topic on your hearing outline and pick up where you left off. In the heat of battle, it is very easy to lose track of where you are with your presentation. The one-page list of topics will allow you to cover all the important points you want to make during the hearing.
 
Source: David Mullens, DPM, JD, How to Win Medicare Appeals
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CODINGLINE CORNER
Query: Alcohol Injection Coding
 
I administered several alcohol shots in October and have received rejections. I have been getting rejections using CPT 64632. Can I resubmit a different code since they no longer pay for the alcohol injection? Perhaps a peripheral nerve block?
 
Benedict Valentine, DPM, Marlborough, CT
 
Response: The injection options for neuroma are:
1) CPT 64455-Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (e.g. Morton’s neuroma)
2) CPT 64632-Destruction by neurolytic agent; plantar common digital nerve
 
What concentration of alcohol did you use? If you used less than 30% alcohol, that is considered not destruction but prolotherapy. CPT 64455 would be correct if you injected anesthetic by itself and/or steroid into a plantar common digital nerve-neuroma using one of the following diagnoses:
G57.61 Lesion of plantar nerve, right lower limb
G57.62 Lesion of plantar nerve, left lower limb
G57.63 Lesion of plantar nerve, bilateral lower limbs
 
If you provide CPT 64632 and as it turns out billed a non-covered service, then you can’t bill another code - only what you billed CPT 64632, then either the patient is responsible or you are based on your contract with the insurance carrier that is not covering the procedure.
 
David J. Freedman, DPM, CPC, Silver Spring, MD
 
For information on Codingline subscriptions, click here
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RESPONSES/COMMENTS (NON-CLINICAL)
From: George Jacobson, DPM
 
We have had this discussion before, but now with volunarily seeing fewer patients per hour, the "No Show" new patients make it harder to recover from this financial disaster. After being closed for 4.5 months due to the lockdown and then open-heart surgery, I began seeing patients 3 weeks ago. We have many 80 to 100-year-old at high risk patients who stayed shut in since March. We referred others and new patients to colleagues. 
 
It's like starting over again, 37 years later, but we have a small base of patients versus zero. I don't recall patients being so rude as to not show up for appointments or not calling if they...
 
Editor's note: Dr. Jacobson's extended-length letter can be read here.
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RESPONSES/COMMENTS (NEWS STORIES)
From: Ivar E. Roth DPM, MPH
 
Congrats to Dr. Irina Gelman for her whistleblower case. I think that amount is one of the largest podiatric fraud settlements.
 
Ivar E. Roth DPM, MPH, Newport Beach, CA
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YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoe of the Day

How a tightrope walker practices?

Source: Marie Weber via Virtual Shoe Museum

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MEETING NOTICES

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Earn 15 CECH only $249 (less than $17 per CECH)

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

NY podiatrists whose licenses expire from 3/2/20-5/1/21 may take all credits online


CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS
ASSOCIATE POSITION – SOUTH WEST FLORIDA 
 
Start Immediately. Walk into a busy schedule day one in this modern, full scope practice. Must be personable, compassionate, motivated, and ABPM or ABFAS BQ/BC. Competitive salary and benefits with clear path to partnership. Excellent opportunity for surgical volume and diversity to accelerate board certification. FL License required. Send CV to podiatrymanda@gmail.com
 
FULL TIME PODIATRIST- NORTHERN NEW JERSEY
 
We are a fast-growing podiatry practice in North Jersey with multiple locations and Doctors.  We are currently looking for a full-time motivated and caring Doctor to join our busy practice. Some benefits include: competitive six-figure salary, generous bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced Doctors as well as new Associates. This is an excellent opportunity to expand your Podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
 
POSITIONS AVAILABLE IMMEDIATELY - ATLANTA, GA AND VICINITY
 
Looking for reliable and ethical podiatrists to service Skilled Nursing Facilities and Nursing Homes in and around Atlanta, GA.  Positions available immediately. Send inquiries and CV to: phasetwopodiatry@gmail.com
 
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA 
 
PSR 24-36 Trained with a current Texas podiatry license. Multi-dimensional, Multi-office group treating a wide range of conditions. A great opportunity for driven personable individual. Please e-mail CV, References Letters, Short Video Introduction Email: cnunez1940@gmail.com
 
ASSOCIATE POSITION - ST. LOUIS, MO 
 
Rapidly growing podiatry practice is seeking a personable, outgoing and self-motivated individual, who is competent in office-based practices but also enjoys all aspects of podiatry.  Position available immediately and offers competitive compensation. Please send CV and letter of interest to podiatrystlouis@gmail.com
 
ASSOCIATE POSITION – LOS ANGELES, CA 
 
Established multispecialty private practice group seeking well trained and ambitious specialist to treat podiatry and wound care patients. Expertise in complex and chronic wounds is needed but residency or wound care certification not required. Full-time and well compensated based on a private practice productivity model with salary and benefits guaranteed. Our experienced team provides beautiful, fully equipped offices with on-site ASCs. We provide trained office staff, marketing and expert revenue cycle management, ensuring doctors can focus on patient care. Excellent opportunity to build a great wound care and podiatry practice as part of a reputable and established company. TWCCJobs@gmail.com
 
ASSOCIATE POSITION - NYC, NY
 
Opportunity available for new Associate/Graduate for Immediate start in modern practice located in NYC. In search of hard working flexible podiatrist with firm verifiable clinical and surgical experience who is willing to travel as needed.  In PDF form, email a letter of interest and resume with references to nynypod7@aol.com for consideration. If both are not received, there will be no consideration. Compensation will be discussed.
 
ASSOCIATE POSITION - SOUTHWEST FL 
 
Immediate Position. Associate for busy practice. ABFAS or ABPM BC or BQ. Great interpersonal skills and willingness to work as a team a must.   EMR, dig x-rays, Ultrasound, DME.  Base salary, bonus, health, 401K, etc. DrLam@NaplesPodiatrist.com
 
ASSOCIATE POSITION – KENTUCKY
 
Associate positions available for well-trained, compassionate physician for busy, established offices in Southern Kentucky. Wide range of services to be offered with ancillary services onsite. Generous salary with incentive/full benefits and partnership opportunity.  Email CV and cover letter to: Kyfootdr@gmail.com 
 
IMMEDIATE OPENING – PENNSYLVANIA 
 
Multi-Office Podiatry Clinic. Hiring both surgical and non-surgical podiatrists. Generous Salary. Bonus pay schedule. Benefits. LARGE SIGNING BONUS. Send CV to Penndoc@Verizon.net
 
ASSOCIATE POSITION - PHOENIX, AZ
 
Well established and growing podiatry practice has an immediate opportunity for an associate as well as July 2021. Must have completed a 3 year surgical residency, have Board Qualification, AZ License and bilingual Spanish is a +. We have several office locations in the Greater Phoenix area ready for someone to make the most of. We have a good balance of office and surgical practice. Base pay with bonus package, with other benefits included. Looking to fill immediately as well as fill July position. Immediate opening must have a current AZ License. Please submit resumes to: podiatryaz@gmail.com 
 
PM NEWS CLASSIFIED  ADS REACH OVER 18,000 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 18,000 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 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
PRACTICE FOR SALE- NYC & LONG ISLAND
 
Selling 3 part-time general podiatry offices, together or separately, well established, excellent growth potential in Bushwick, Brooklyn, Rego Park, Queens and Franklin Square, Long Island. All fully equipped with very low overhead. Priced to sell. Turn-key, will transition.  Great starter office or secondary office. wperez1000@gmail.com
 
PRACTICE FOR SALE - GETTYSBURG, PA 
 
Well established, 25 year old, full scope podiatry practice for sale. One full-time, 5 days/week, associate and one owner practicing one and a half days/week. Consistently collecting $700,000/year. Profit from practice over and above your income from seeing patients from year one. Owner will stay for transition and business consulting. drhenrock@yahoo.com
 
PM NEWS CLASSIFIED  ADS REACH OVER 18,000 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 18,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details.
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.
Guidelines
  • To Post a message, send it to:    bblock@podiatrym.com
  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
  • Notes must be in the following form:
    RE: (Topic)
    From: (your name, DPM)
    Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
    Your name, DPM City/State
  • Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.

Barry H. Block, DPM, JD
 
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