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PMNews
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| PM News | |
The Voice of Podiatrists
Serving Over 17,210 Subscribers Daily
February 23, 2016 #5,606  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2016- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
Quick Poll
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How do you see the trend with podiatrists as part of orthopedic groups? |
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| PODIATRISTS AND PODO-PEDIATRICS | |
MA Podiatrist Conducts Webinar on Down's Syndrome
Recently, Dr. Louis J DeCaro, President of the American College of Foot & Ankle Pediatrics conducted a webinar broadcast nationally for the National Down Syndrome Society. Titled “How Early Intervention in Pediatric Foot Care Can Improve Quality of Life in Children with Down Syndrome,” Dr. DeCaro discussed how the growing foot structure/shape in children with Down syndrome influences balance, gait, and a variety of foot conditions that can be treated during early development. Common symptoms include flat feet, pronation, foot/leg pain, toe-walking, in toeing, and others.
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Dr. Louis DeCaro |
“The feet are the foundation of the body, and from the first step a child takes, deficiencies in the lower extremity begin to create a destructive domino effect on the rest of the human body. Children with the diagnosis of Down syndrome are certainly no exception. Podiatric physicians offer an important role in quality of life for children with Down syndrome. It is important we get the word out,” DeCaro said during the webinar.
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| INTERNATIONAL PODIATRISTS IN THE COMMUNITY | |
Despite Budget Cuts, UK Private Podiatry Clinic Opens
Steps have been taken to put private foot care at the heart of Immingham – after council cuts forced the closure of its original base in the town. Due to budget cuts within the council, the building closed and this service had to end as a result. But after speaking with regular clients from the Immingham area, staff at the Achilles Centre on Dudley Street realized there was still a need to provide a private podiatry service.
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(L-R) Podiatrist Angela Cottingham and podiatry assistant Emma Warrener |
The Achilles Centre has begun renting rooms at the Pilgrim Primary Care Centre in Pelham Road, Immingham, to provide this service, initially for one day a month to monitor the exact need for the service. Podiatrist Angela Cottingham said, "We did our first clinic last month and are due to do one next Thursday. Staff are also qualified to administer local anesthetics and surgically remove toe nails, in state-of-the-art clinical conditions.
Source: Grimsby Telegraph [2/20/16]
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| FROM PM's CURRENT ISSUE | |
Twice 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.
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| Today's featured article |
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| MEDICARE NEWS | |
CMS Proposes 1.35% Medicare Advantage Rate Hike for 2017
Baseline Medicare Advantage payment rates for 2017 will rise by 1.35% on average, an early win for health insurance companies in what is the final Medicare rate battle of the Obama administration. When factoring in the risk coding tendencies, the average change in Medicare Advantage insurers' revenue will climb 3.55% next year, according to a CMS release posted late Friday. The proposal is a major shift from last February, when initial benchmark rates were cut by an average of 0.95% before factoring in risk score trends.
The 2017 proposal again makes changes to the program's risk-adjustment model. Medicare Advantage insurers document the health status of their members by using risk scores that adjust for different demographics and conditions, known as hierarchical condition categories. A higher risk score indicates a person is sicker or has complicated chronic health conditions, which leads to a higher payment.
Source: Bob Herman, Modern Healthcare [2/19/16]
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| SUCCESS TIPS FROM THE MASTERS | |
Bret Ribotsky: March 15th is the deadline for filing a meaningful use hardship exemption. Please explain the effect of checking box "2.2.d".
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Dr. Jeffrey Lehrman |
Jeffrey Lehrman: The exemption is just for avoiding the penalty. Box "2.2.d" is the one to use if you could not attest to 2015 Meaningful Use as a result of the government not releasing the requirements with enough time left in the year. Note that if you claim this exemption, any incentive payments that would have been received last year are forfeited. That means that if you were to have received $7,800 in 2016 for 2015’s work, that money is gone.
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Dr. James Christina |
Meet the Masters airs live every Tuesday night. This week's guest will be APMA CEO and Executive Director Dr. James Christina. You can register for this and future events by clicking here
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| QUERIES (NON-CLINICAL) | |
Query: Running a Satellite Office and Adult Living Facility After Selling the Main Office
I am contemplating selling my main office but continuing to work in a satellite office and an adult living facility. If there is anyone who has done something similar, I would like to know how you handle telephone calls of patients wanting to make an appointment, etc. Our practice management system is web-based so we do have easy access to the appointment book.
Would you recommend an answering service, dedicated cell phone line, or maybe an answering machine? Obviously, I would like a system to be as least intrusive to us as possible during our off time, but at the same time be able to offer a professional representation of our office to patients. Any recommendations would be appreciated.
Editor's comment: PM News does not provide legal advice. The initial issue you need to settle is agreeing with the buyer on a fair restrictive covenant. A potential buyer would certainly be concerned with retaining as many patients as possible without the prospect of losing them to a satellite office.
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| CODINGLINE CORNER | |
Query: Plantar Fasciitis Injection Rejection
An established patient with Cigna Health and Life presents with plantar fasciitis/heel pain left foot. He was treated with a cortisone injection. We billed as follows:
CPT 99212-25 [M72.2 (plantar fibromatosis); M79.672 (pain in left foot)]
CPT 20550 [M72.2 (plantar fibromatosis); M79.672 (pain in left foot)]
J0702 [Celestone Soluspan - same diagnosis codes as above]
The office visit was paid at a reduced fee, but the injection was denied as non-covered charges. What would be the correct way to code this?
Steven Rothstein, DPM, Manchester, NH
Response: On an established patient, the E/M is supposed to only be done if you perform a significantly and separate evaluation and management service. The pairing of the E/M service with the plantar fasciitis injection in your post does not reveal what it was that made it separate and significant. If it was, then you should contact CIGNA to find out why you were denied.
Your post noted that you did append a "-25" modifier to the E/M code. Both the E/M service and the injection should be paid on its own merit if your documentation backs up both. If you have a good solid note meeting the definition of the E/M and the injection, and they can't correct it over the phone, then appeal for coverage on both services.
David J. Freedman, DPM, CPC, Silver Spring, MD
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Don Peacock, DPM
The symptoms suggest a neurological component to your patient’s pain. It's probable that an impingement of nerve structures in the tarsal tunnel area is the culprit. It is also possible that there is a concurrent impingement dorsally in the deep peroneal which can lead to allodynia.
Specifically, the pain distribution makes it highly suspect that the impingement is at the porta pedis. If you press hard with your thumb in this area, it should illicit pain but not necessarily a Tinel's. I suggest an anesthetic block at the porta pedis and give it 5 minutes to see if the pain resolves. If it does,...
Editor's note: Dr. Peacock's extended-length letter can be read here.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Michael M. Rosenblatt, DPM
Any patient with recalcitrant pain that is not "well managed" by the usual patterns of podiatric care should be evaluated for a general medical condition. For example, hyperuricemia is usually thought of as resulting in pain that affects joints, and for the most part that is true. But there can be atypical presentations of pain caused by hyperuricemia, and this includes heel/plantar fascia pain.
A common pattern for patients with gout is excessive use of ETOH. This causes dehydration and major shifts in uric acid metabolism. Sometimes, patients with extremely high cholesterol and fatty acid lab reports see "unexpected and not usually connected" symptoms. I have seen patients with...
Editor's note: Dr. Rosenblatt's extended-length letter can be read here.
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
From: William Deutsch, DPM
Dr. Baum sees podiatry morphing into a strictly surgical specialty; otherwise, why spend 3 years perfecting callus removal and nail cutting? Of course, there's plenty more to non-surgical podiatry, but if insurers are going to continue cutting reimbursements and rejecting more services as non-covered, the economics will dictate the podiatrist's future.
If the vacuum, created by relinquishing palliation and non-surgical foot care becomes great enough, it will be filled by PAs, nurses specializing in foot care, and pedorthists. Insurers would love that. And a new sub-specialty will have been created as nature abhors a vacuum. But maybe it's a good first step towards a degree change in podiatry's quest for parity with the MD. As the line blurs between podiatrist and orthopedist, the competency question will change to wonder why podiatry isn't receiving parity and isn't simply another medical specialty of the physician or osteopath.
Of course, a straight-up recourse would be for all existing podiatry schools to relentlessly pursue every medical and osteopathic school in the U.S. and explain how affiliation and incorporation of podiatry as another physician specialty and not a separate medical entity would benefit the medical community, the government's quest for exemplary healthcare, and the caliber of student entering the profession. Economically, it wouldn't hurt the medical school either.
William Deutsch, DPM, Valley Stream, NY
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Available Immediately!!
The New, Revised, More Inclusive, Updated, 2016 Podiatry Coding Manual
From Michael G. Warshaw, DPM, CPC
It has been fully updated for excellent readability, reference and completeness. The most appropriate ICD-10-CM codes have been added to all procedures. Now link ICD-10 codes to CPT codes using the ICD-9 to ICD-10 Crosswalk. It is the highest of quality and podiatry information to aid in coding and billing for appropriate reimbursement and documentation to support what was billed. You will see why so many podiatry offices across the country refer to this book as their “Bible” when it comes to billing, coding, and documentation.
Only $125.00 including shipping!!!
Available in Book, CD, and Flash Drive Formats
No credit card? No problem. Just mail a check or money order to:
Michael Warshaw, DPM, CPC, 1837 Puerto Bello Drive, Lady Lake, FL 32159
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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"Knot" your typical sandal clog! |
Source: Numeroventuno via Virtual Shoe Museum
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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
(Only $14 per credit) http://www.podiatrym.com/cme.cfm
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 |
ASSOCIATE POSITION – NORTH TEXAS
Are you looking for a group practice in North Texas? Do you like a fast paced environment? Are you board qualified or certified in surgery? Can you start as early as this summer? If you answered yes to ALL of these questions, please send an email to greatplacetowork@faant.com with the caption "I'm your next associate" in the subject line.
ASSOCIATE POSITION – SOUTHERN CALIFORNIA
Are you finishing your residency in June? Full-time associate leading to partnership. Immediate position available. Busy office with multiple locations. Full scope practice. ABPS Board qualified/certified. California license required. Benefits included. Inland Empire. Please forward resume to familyfootcenter@verizon.net
ASSOCIATE POSITION - DALLAS/FT. WORTH TEXAS
A multi-office practice is seeking a well rounded podiatrist with strong work ethic and skills. Must be BQ/BC by ABFAS. Competitive salary, bonus structure and benefits. Excellent growth potential for the right individual. Position available this July. Send CV, picture and letter of interest to: ntexaspod@gmail.com
ASSOCIATE POSITION - TAMPA BAY
Well established, dynamic multi-doctor practice in the Tampa Bay, high-tech with EMR and digital x-rays. Sports medicine, surgery and potential partnership. No NH/ HMOs. Excellent hospital privileges. Choose an area of practice concentration that you are passionate about & enjoy a lifestyle 2nd to none. CV to floridapodiatrist@tampabay.rr.com
ASSOCIATE WANTED - WESTERN NY/PA
Busy multi-location practice seeks personable energetic hardworking podiatrist. Come utilize the full extent of your Podiatric training! Competitive salary, bonus, and partnership. NY/PA license required. Send CV to: jhs.podiatry@gmail.com
ASSOCIATE WANTED - NORTHERN VIRGINIA
Seeking an associate to join our practice now or summer who is ethical, skilled, hard working, personable to join our team. Candidate must have a minimum PMSR/36 with RRA training. Must be BC or BQ. Open also to already established seasoned podiatrist. Email to: novapodjobs@gmail.com
ASSOCIATE POSITION - NEW JERSEY
Seeking energetic podiatrist. You must be trained in all aspects of Podiatric Surgery including forefoot and rearfoot surgery. Be willing to follow and learn proven systems for practice success. Competitive remuneration package. Position available for Summer 2016. If you meet all these qualifications, please apply with CV attached. njpod2013-1@yahoo.com
ASSOCIATE POSITION – WISCONSIN
Our well established podiatry practice in central Wisconsin is looking for a full-time Podiatrist to join our team and who enjoys developing long-term care relationships with their patients. Position will involve seeing patients at Clinic, Assisted Living Facilities, Surgery Centers and Hospitals. Very competitive salary tgleason@familyfoot.org.
ASSOCIATE POSITION - EAST TEXAS
A well-established practice is seeking a full time associate podiatrist. Must be BC or BQ by ABFAS. Practice offers a good general mix of all aspects of podiatric medicine and surgery. Competitive salary and benefits/Partnership buy-in. Email CV and letter of interest to office manager at toejob40@yahoo.com.
ASSOCIATE POSITION – YONKERS, NY
Well established podiatry practice is looking for part-time podiatrist to work 2-3 days per week, including some Saturdays. Will work to get you on as many plans as possible. Competitive compensation package with bonus structure & partnership/ownership opportunity for the right individual. Please submit resume: Podiodoc@gmail.com
ASSOCIATE POSITION – MASSACHUSETTS
We are a well-established, very busy, hospital-based multi-doc practice located just north of Boston, seeking full time podiatrist. Excellent referral base and high volume of new patients. We are well integrated within the medical community and active in both hospital out-patient and in-patient care. Competitive compensation and benefit package. Please email CV to footdocsma@gmail.com
ASSOCIATE POSITION - KANSAS CITY (MO) SUBURBS
Not just another job. Associate needed for busy multiple office practice. Three-year surgically trained, either board certified or qualified. Busy surgical practice with strong office volume. Competitive salary and benefits. Partnership track. Send resume to MCrosby518@gmail.com
POSITIONS AVAILABLE - BUFFALO, ROCHESTER, SYRACUSE, AND SURROUNDING AREA
Looking for podiatrists to see residents in nursing homes and skilled nursing facilities in Buffalo, Rochester, Syracuse, and their surrounding areas. Great opportunity for full-time or part-time income. Positions available immediately! inquiries to: phasetwopodiatry@gmail.com
ASSOCIATE POSITION - LOUISVILLE, KENTUCKY
Excellent opportunity to join a busy high visibility office with digital x-ray, diabetic shoe store, and 5 years experience in EMR. All phases of podiatry. Good patient volume, lots of DME, and steady reliable income stream. Potential for partnership or purchase. Contact samuel10530@yahoo.com
ASSOCIATE WANTED - SO CAL COAST
Excellent opportunity for the right doctor. Looking for a young, hard working, full time doctor who wants to learn how to run a practice from top to bottom. Need an outgoing, very personable doctor to shadow me and practice similarly. Want someone who would want to take over the practice in the near future. asbf@pacbell.net
ASSOCIATE POSITIONS - FLORIDA
KG Health Partners, Inc., the largest mobile podiatry service in Florida has openings for full time podiatric physicians servicing SNFs, ALFs and Senior Independent Living located throughout Florida. Physicians are provided local facilities, assistants, administrative support including scheduling and billing. All expenses including malpractice insurance, travel allowance, etc. are covered. Exceptional benefit package includes paid holidays, vacation, 401K retirement plan with company match as well as excellent health insurance. First year six figure salary is guaranteed! Second year profit sharing. Most second year doctors earn $150,000 and up. FL License required.Email CV to Rob Cash admin@KGHP.net
ASSOCIATE POSITION - TEXAS - DALLAS SUBURBS
Seeking well rounded individual to join our well established, modern practice. Surgery, orthopedics, wound care, primary care and sports medicine. Very competitive salary with bonus structure and benefits. Early partnership opportunity for the right person. This is a rare opportunity. Please send letter of interest and CV to: Podiatrysbest@gmail.com
WOUND CARE FELLOWSHIP - NEW YORK
CPME-approved 12-month fellowship beginning July 1st, 2016. Hospital and clinic environment with on-site hyperbaric medicine. Work with infectious disease, vascular, general, and podiatric surgeons in wound management. Must have completed a 3-year PMSR program. Please contact drarnoldhertz@aol.com OR jtfootcare@gmail.com EOE
FELLOWSHIP – DIABETIC FOOT & WOUND (TEXAS)
One position for a 12-month TMB-approved Diabetic Foot and Wound fellowship beginning July 1, 2016. Candidate must have completed a podiatric residency/plastic surgical residency/general surgery residency and be eligible for Texas Medical License. Training involves all aspect of diabetic foot management. Curriculum focuses on surgical limb salvage, and medical management of the complex wound patient. Interested candidates should email their CV, personal statement and 3 letters of recommendation to latonya.rosales@utsouthwestern.edu. UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.
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 (800) 284-5451.
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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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