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| PM News | |
The Voice of Podiatrists
Serving Over 17,555 Subscribers Daily
February 10, 2017 #5,860  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2017- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
LAST CHANCE TO VOTE
Quick Poll
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For Medicare payments for x-rays since the start of the year, have you been: |
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| PODIATRISTS AND FOOTWEAR | |
Worn Heels Mean It's Time to Replace Shoes: PA Podiatrist
Have you ever noticed that one side of the bottom of your sneaker’s heel can be more worn-down than the other after a couple months of use? It’s a very normal phenomenon, according to Jane Pontious, DPM, chair of the department of podiatric surgery at Temple University School of Podiatric Medicine. Your heel, positioned directly below your body, supports all of your weight. We all walk slightly differently, so it makes sense that some people may lean more on one side of the shoe than the other.
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Dr. Jane Pontious |
However, that doesn’t make it healthy for your foot and ankle to be put in this imbalanced position in the long-term. “People will look at the sneaker and say, ‘Well, it’s new,’ and I’ll say, ‘Look at the heel. You’re no longer standing normally, so you have to replace it,’” says Dr. Pontious.
Source: Clare Varellas, Readers Digest
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| PODIATRIC EMPLOYEES AND THE LAW | |
KY Podiatric Assistant Filled Fake Prescriptions for Years
To feed her opioid addiction, a Louisville woman, for years, filled fraudulent prescriptions under her family members' names, police said. Margaret Lyn Harp, who also uses the last name Staples, was arrested Tuesday. She is charged with 12 counts of unauthorized procurement of a controlled substance — in this case, hydrocodone.
Harp abused her position as a medical assistant to a local podiatrist to fraudulently write prescriptions using the doctor's name, according to an arrest citation. Starting in February 2015, Harp wrote and filled numerous prescriptions under the names of her two sons and her husband.
Source: Danielle Lerner, Courier-Journal [2/8/17]
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
6 Signs It's Time to Fire a Staffer - Part 5
Here are six signs that it is time to fire an employee:
5. They create drama and hostility in the work place. We don't have time to play kindergarten cop. Our focus should be on our patients, not on petty fights. It is my experience that it is usually just one employee creating division among the other employees. If you uncover that person, you know who has to go.
Source: Linda Girgis, MD, Physicians Practice [1/24/17]
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| CODINGLINE CORNER | |
Query: Plantarflexed Metatarsal
I have a new Medicare patient who presented with a plantarflexed 5th metatarsal and localized bursitis. I evaluated the patient and gave an injection of lidocaine and dexamethasone, along with an off-loading pad. What ICD-10 and CPT codes would you suggest?
Adam Klein, DPM, Lynbrook, NY
Response: The ICD-10 code I suggest for the plantarflexed metatarsal, I believe, would be: M21.6X1 Acquired foot deformity, right; or M21.6X2 Acquired foot deformity, left.
For the injection, I would use CPT code 20600 – presuming the injection is in the foot with the ICD-10 code M77.51, other enthesopathy of right foot; or M77.52, other enthesopathy of left foot, whichever is appropriate.
Be sure to bill for the dexamethasone using HCPCS J1100 (dexamethasone 4 mg/ml [1 unit]).
Joseph Borreggine, DPM, Charleston, IL
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Ben Cullen, DPM, Donald Brann, DPM
There is no "gold standard" diagnosis of osteomyelitis. See the JFAS article referenced below wherein 4 pathologists studied bone specimens and only were in agreement 33% of the time. The diagnosis is made based on a preponderance of evidence, which is definitely present in your situation with the clinical findings and appearance on MRI. It's nice when pathology results are consistent with what you see, but it's not a requirement for confirmation.
Meyr AJ, et al., Statistical reliability of bone biopsy for the diagnosis of diabetic foot steomyelitis. J Foot Ankle Surg. 2011 Nov-Dec;50(6):663-7. doi: 10.1053/j.jfas.2011.08.005. Epub 2011 Sep 9.
Ben Cullen, DPM, San Diego, CA
It sounds like you're suggesting the pathology report is faulty. It's not. The pathology findings will always outweigh the MRI findings. MRI is ultra-sensitive but not necessarily ultra-specific in this scenario. MRI findings are frequently "over-read", and therefore should be interpreted with due caution and regard for the clinical/operative findings. Edema of the 5th metatarsal, for example, is NOT diagnostic for osteomyelitis of the entire bone. At a minimum, bone quality/ hardness can be assessed while doing a more limited resection of the metatarsal head/neck. Post-operatively, If wound quality doesn't improve or infection persists, return to the OR for additional bone resection may be necessary.
Donald Brann, DPM, Orland Park, IL
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Ira Baum, DPM
Based on the intra-operative information, a choice was to be made. Resect what you judged to be infected bone, or flush and pack the wound and follow the standard course of antibiotic therapy directed by an infectious disease specialist. It was not an easy decision, but I think your decision was correct and appears to be done in the best interest of the patient. The pathology report does not include the clinical appearance at the time of the operation, and therefore has limitations as evidence of wrongdoing. Having said that and your concern of a malpractice incident, the obvious now comes into focus: Impecable progress notes and photographs demonstrating progress.
Ira Baum, DPM, Naples, FL
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| RESPONSES/COMMENTS (CLINICAL) - PART 1C | |
From: Name Withheld
I had a very similar situation. The patient was type 2 diabetic, 50 years of age, and had been seeing me for a plantar callus on his foot for two years. Conservative treatment consisted of Q 1-2 month debridement of his callus. I suggested orthotics and Spenco insoles with accommodation to off-load the callused area and overall decrease stress on his foot.
In addition, I suggested and expressed importance of wearing proper fitting shoes. He consistently wore improper width shoes and sandals with no shock-absorbing insole. By not wearing at least OTC arch supports and...
Editor's note: To read this extended-length letter click here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Feet of the Day
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Two Feet of Snow |
Source: Submitted by multiple podiatrists
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 CPME-Approved CME Contact Hours Online
Earn 15 Contact Hours only $210
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All required credits can be taken online for AL, AK, AR, CA, CO, CT, DE, HI, IN, KS, KY, LA, MA, ME, MD, MI, MN, MI, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, WV, WI, & WY
Partial required credits can be taken online for AZ, CT, FL, GA, ID, KY, IL, IA, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, VT, WA, and DC
Choose any or ALL from 30+ CME Category-1 articles posted
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| CLASSIFIED ADS - PART 1- ASSOCIATE POSITIONS AND FELLOWSHIPS |
PRECEPTORSHIP WANTED
Preceptorship wanted, for additional information please call 843-773-1846 or email drjnoel8@gmail.com
LOWER EXTREMITY PERIPHERAL NERVE SURGERY FELLOWSHIP POSITION
EHI Pain and Neuropathy Center -Atlanta, GA. This fellowship is under the direction of Dr. Stephen L. Barrett, and is an Association of Extremity Nerve Surgeons (AENS) Peripheral Nerve 12-month approved surgical fellowship program. Start date is July 1st, 2017. Salary: $ 50.000 + benefits (CME, health insurance, etc.) The nerve fellow will be enrolled in the AENS surgical fundamental course, and will only focus on lower extremity nerve surgery throughout the fellowship. Submit letter of introduction and CV with medical school transcript to dfell@extremityhc.com. GA license required. Deadline for applications is March 10th, 2017.
ASSOCIATE POSITION - ST. LOUIS, MO
Expanding group practice seeks full-time podiatrist to join our team, we have state of the art facilities with EHR, lasers, EPAT, digital x-ray, etc. Candidates must have completed a PSR/36 residency and be well-trained, ethical and collegial. Competitive salary with incentives and benefits. If interested, please Contact CHARLENEW@FACSTL.COM.
ASSOCIATE POSITION - RHODE ISLAND
Well established practice seeking a part time podiatrist leading to a full time position. We have state of the art facility with EHR, Laser, PADNet, and Digital x-ray. Great referral base with hospital and surgical center privileges. All aspects of podiatry are seen from simple to complex, children to geriatrics. No nursing homes. Interested candidates send CV to ripodiatryassociate@gmail.com.
ASSOCIATE POSITION – SOUTH CAROLINA
South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary and next exam is June 2017. Starting Compensation package $120k-$140k (base + bonus), health insurance, paid vacation, CME allowance, and retirement. Please send Letter of Interest and CV to: scdpmjobs@gmail.com
IMMEDIATE ASSOCIATE OPPORTUNITY – CHICAGO
Multi-location group-Chicago/Near West Suburbs - Opening for ABFAS Board Certified/Qualified associate for Chicago. Surgical/ortho patient load. No nursing homes. Must hit the door running! EMR, digital x-ray, laser, ultrasound, shockwave, surgery center & amazing support staff. Benefits available, associateship available for the right doc. Send CV to chicagopodwork@gmail.com
ASSOCIATE POSITION – SOUTHERN MARYLAND
Established practice in Southern Maryland looking for a full-time podiatrist. The ideal candidate will have strong clinical skills including ulcer care, diabetes and general footcare. Must have a strong office personality with the ability to maintain and attract patients. Advanced surgical training, evenings/weekends and E/R- on call not required. Please send C/V to: feet_r_neat@aol.com.
POSITIONS AVAILABLE - IN, TN, TX, MO, KS, WI
Preferred Podiatry Group is seeking providers to join our growing practice servicing long term care facilities in several areas. We offer a competitive commission based income as well as a benefits packaged to our employed podiatrists. Full-time and part-time positions are available. Contact Dr. Chris Kestner at ckestner@ppgpc.com for details.
IMMEDIATE ASSOCIATE POSITION AVAILABLE – INDIANAPOLIS
For motivated, hard-working residency-trained podiatrist in busy 3-office practice leading to partnership. Would consider 2017 residency graduate. Two locations in Indianapolis and 1 location outside of Metro area. Competitive salary and benefit package including 401, profit-sharing, Health insurance. Surgery center ownership available. Forward letter and resume to Imalament1@comcast.net.
ASSOCIATE POSITION - HARTFORD COUNTY, CT
Well-established, busy podiatric practice seeking a candidate who is dedicated, hardworking, motivated with an excellent bedside manner. The practice sees all age groups and all aspects of podiatry from simple to complex. Seeking a long-term team player dedicated to patient care and has the ability to work independently. Send CV to ct_footdoc@yahoo.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.
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| CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE - CALIFORNIA: NORTHERN
Wanting to retire. Looking for someone to take over practice. Great opportunity. Ready patient base. Potential to expand in all areas of podiatry. Awesome area - lakes, mountains, rivers - especially appealing to outdoor enthusiast/anyone who enjoys beautiful locale. $285,000 buys building and well established practice. Email reddingpodiatry@sbcglobal.net
PRACTICE FOR SALE - LOS ANGELES COUNTY SUBURB
Golden Opportunity- Gross is over $500,000.00 on only 2 days. Easily expanded to full time practice. Full mix of patients- private, Medicare, HMO. All phases of podiatry practiced- surgery, wound care, maintenance, biomechanical. Be your own boss. Interested parties send email to footguy1@pacbell.net
PRACTICE FOR SALE- MASON CITY, IA PRICED TO SELL
Well-established, full range, solo podiatry practice for 34 years. Located in professional building next to hospital. Fully equipped with digital x-ray system. Currently 3 days/week, 5-year average gross $409K and $265K net with growth potential. Call 641-423-1565 after 5PM (CST) or e-mail sbrau@mchsi.com
EQUIPMENT FOR SALE - PINPOINTE LASER
Excellent condition, 4+ years old, was used only twice/month in satellite office. Protective eye wear included. $10,900 Mwolpafootdoc@yahoo.com (510)-849-3800
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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.
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| 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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