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The Voice of Podiatrists
Serving Over 15,770 Podiatrists Daily
March 05, 2014 #5,004  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2014- 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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Which of the following most closely reflects the malpractice insurance you carry? |
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| ACFAOM NEWS | |
ACFAOM Adds Two New Members to Board
As her final act as ACFAOM’s president on January 23, Dr. Kathleen Satterfield announced the results of the membership election of two new board members: Drs. Javier Cavazos (TX) and Terry Weaver (PA) with terms beginning January 1, 2014.
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Drs. Javier Cavazos and Terry Weaver |
The following officers were also elected for 2014: Dr. Stephen Albert (CO), President; Dr. Daniel Evans (IL), Vice President; Dr. Jason Harrill (AZ), Treasurer; and Dr. Coleen Napolitano (IL), Secretary. Dr. Kathleen Satterfield (CA) remains on the board as Immediate Past-President. Leaving the board were Drs. Kirk Geter (DC) and George Wallace (NJ).
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| SUCCESS TIPS FROM THE MASTERS | |
Bret Ribotsky: What can you do to prevent actions against your podiatry license?
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Dr. Beth Pearce |
Beth Pearce: Keep your CMEs up-to-date. Communicate with your patients. Keep within your office manual guidelines when dealing with staff. Should you move or add a new location, make sure to let your licensing board(s) know.
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Dr. David Freedman |
Meet the Masters airs live every Tuesday night. This week's guest will be ICD-10 Coding specialist Dr. David Freedman. You can register for this and future events by clicking here
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| CODINGLINE CORNER | |
Query: CAM Walker Modifier
I have placed a diabetic patient with a calcaneal fracture in a CAM walker type boot (L4382) which was then denied by DMERC stating "procedure code is inconsistent with the modifier used or a required modifier is missing." We submitted this with these codes and modifiers "RT" and "Q9". ICD-9 825.0 (calcaneal fracture); ICD-9 250.60 (diabetes mellitus with neuropathy); and ICD-9 729.5 (pain). Place of service 12 (home). Any idea why this was denied, and what modifier are we missing?
Mark Ray, DPM, Latrobe, PA
Response: The "Q" modifier is ONLY to be used when qualifying vascular-based at-risk status for routine foot care. It is not to be used for other services or DME coding. Using a modifier incorrectly could result in a claim denial. You are missing the "KX" modifier which indicates that the requirements of the policy have been met regarding the walking boot.
Tony Poggio, DPM, Alameda, CA
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription
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| RESPONSES/COMMENTS (CLINICAL) - PART 1 | |
From: Robert D. Phillips, DPM
One of my mentors, Leonard A. Levy, DPM, taught me this maxim: We don’t treat foot problems; we treat people with foot problems. The x-ray looks like the patient may have agenesis of the distal phalanges of the 3-5 digits. However, the big issue with this patient is not going to be the size of the toe; it will be how to fit shoes and the social impact this deformity will have on this young person’s life while growing up. I’m not sure where you live, but with the current cold weather in much of the nation right now, what type of foot protection is this patient getting from the weather? What type of shoes are you going to recommend this young person wear while you wait until skeletal maturity? What does the contralateral foot look like?
You actually have more social issues here than foot problems, and you’re going to need a lot of input from child psychologists as well as the parents themselves, because they’re the ones who are going to have to deal daily with the issue when other kids make fun of little Johnny/Suzie because of the funny feet. What the parents will accept and be willing to live with are probably your biggest questions that need to be asked.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2 | |
RE: Pernio vs. Raynaud's Disease (Jeffrey Kass, DPM)
From: Dennis Shavelson, DPM, Wm Barry Turner, DPM
I recommend posterior tibial or popliteal nerve blocks (assuming viable circulation).
I have been seeing prescriptions by my patients' primary care physicians for amlodipine besylate. It is a cardiac medication, a calcium blocker with qd dosing, and seems to be helpful when treating Raynaud's. Regenecare, a topical wound care product, contains lidocaine. How long it works, I do not know. I have been using it with some benefit for ischemic wounds. In regard to nitroglycerin paste, I am a long-time supporter and prescriber, but I do not forget that the patient develops tolerance to the dosing. The systemic results are better with nitroglycerin than they are with topical Procardia.
Currently for vasospastic conditions like Raynaud's, I am contacting the patient's PMD and recommending amlodipine 5-10 mg p.o. qd. I prescribe nitroglycerin paste (1/2 inch rubbed in to the calf or arch, tid) for flare-ups and seasonally, as indicated by the pathology. Keep in mind that the patient must maintain a systolic blood pressure over 100 mmhq when prescribing nitro paste. I do a trial in my office and chart the patient's response and V/S before and 5 minutes after application.
I bill for the additional time or escalate the level of office visit for billing. You and the patient will typically see increased perfusion in just 90-120 seconds. For more information regarding the prescribing of nitro paste, feel free to contact me.
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
From: Brian Kashan, DPM, Philip J. Shapiro, DPM
I agree that patients are increasingly asking to take pictures of their feet post-operatively and even taking pictures of ingrown nails I remove. I have no problem with that, as they can take the same picture at home if they really wanted to. However, I do not think it is normal or recommended that you subject yourself to, what amounts to, a patient-controlled deposition! I believe that is ludicrous. Was the initial conversation recorded when you reviewed your post-operative instructions and initial consultation? Also, you have no idea who the person with the patient is. The person can be an attorney who has an interest in pursuing a claim, and you are a sitting duck in your own office without representation! That is an arena we should avoid.
Since this is just my feelings, and what I would do when faced with that situation, my strong suggestion is to speak to your malpractice carrier. Whatever they advise is what I would do as they are the experts. My guess is that pictures are okay, but absolutely no recordings. I am interested to hear the responses from the legal experts.
This interesting question might best be answered by legal counselors. Overall, patients bringing technology into the treatment and presentation process is not a rarity, but given that this patient was having complications, it raises the unsettling question as to the motives of recording your words. I believe that you did the right thing under the circumstances, but again, I believe that legal counsel should address this matter for the readers.
Editor's comment: PM News does not provide legal advice. We know of no law that gives patients the right to videotape treatments or consultations. Because this request is problematic, we would post a sign saying "cell phone use and videotaping are prohibited in treatment and consultation areas."
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| RESPONSES/COMMENTS (PROFESSIONAL DISCIPLINE) | |
From: Simon Young, DPM
I truly feel for Dr. Lawrence's plight, and hope I am never in such a situation. Once he signed on the dotted line without proper legal representation, the ball game was over. Even if you donate your services, you still must follow state law and are liable for the consequences.
After 35 years in practice, it's sad to hear that he didn't have enough resources to hire an attorney. Was Legal Aid, PICA, or a state society lawyer available to guide him (at a discounted rate) through his travail. Nevertheless, no one should ever sign such a legal document at any cost without some sort of legal representation and without understanding the consequences. Your side of the story is moot, and you need to be aware of collateral potential damage which might follow. I wish Dr. Lawrence the best.
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MEETING NOTICES - PART 1
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| CLASSIFIED ADS |
EQUIPMENT FOR SALE - PINPOINTE FOOT LASER
$16,800.00 OBO, FDA-cleared to treat Onychomycosis. Purchased May 2011, Machine was maintained under warranty and is in working order. Includes; manuals, keys, thermometer, 1 hand piece, new fibers, cleaver, 3 pairs of eye goggles, original packaging. Contact -Darren @ 801-870-4161 or email:dman1hansen@gmail.com
INTERN POSITION - ILLINOIS
Part-time paid intern position for current podiatry resident to assist with various projects in a new podiatry practice in the Midwest. Most, if not all of the requirements of the position can be completed via phone and Internet. Please respond with CV, contact information and any questions to podiatryintern@gmail.com.
ASSOCIATE POSITION - NORTH CAROLINA - GREENSBORO/TRIAD AREA
Busy, state-of-the-art group practice seeking full time associate. PSR 24 or above training preferred. Excellent opportunity for a highly motivated and ethical applicant. Competitive income and benefit package. Hospital privileges available. Board certified/qualified applicant, send CV and letter of interest to triad.podiatrist@yahoo.com
ASSOCIATE POSITION - CENTRAL FLORIDA
Non-surgical associate wanted for busy Central Florida practice. Duties to include palliative care, diabetic foot care, wound care and minor office procedures. Competitive salary plus incentives, malpractice insurance, health insurance, fees and dues, are covered. Please reply to: footcareforyou@gmail.com.
ASSOCIATE POSITION - NY (ROSLYN AND HUNTINGTON)
Join one of the largest podiatry groups on the East Coast. Well established and progressive offices, including EMR, digital x-ray, PVR and NCV studies, PinPointe laser, and Microvas therapy. For more info, www.GreatFootCare.com. Send resume to Dr.Kassaris@yahoo.com.
ASSOCIATE POSITION - CENTRAL PA
Looking for an associate with strong surgical training. Personal and energetic a must. The physician will provide all aspects of podiatric practice, including sports medicine, wound care, and foot and ankle surgery. Competitive compensation package. Partnership opportunity for right person. To apply, please email, letter of intent and CV to premierfootpa@outlook.com
ASSOCIATE POSITIONS – TENNESEE
Immediate full & part-time positions available for fully credentialed. Buy in/Buy out options available for this high volume practice in Knoxville area. Principal, also seeking like-minded to share semi-retirement, e.g., 2 weeks on/ 2 weeks off or 1 month on/ 1 month off, etc. Please email letter of intent and CV to:easttnpodiatry@gmail.com
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Multi Physician Practice – Multi Practice Locations Competitive Salary and Benefits. Experienced support staff. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
ASSOCIATE POSITION – CHICAGO, IL
Podiatrist in Chicago. Independent, energetic Dr. needed to do house calls; schedule will be accommodated due to Dr.'s preferences; both full- and part-time will be considered. Send your inquiries to: dpms2@hotmail.com
ASSOCIATE POSITION - UPSTATE SC
Well-established three doctor practice seeks PSR-24/36 trained associate. New office building with privileges at nearby hospital and surgical center. EMR in place. Located near lake and mountains. Two hours from Charlotte and Atlanta. Please send letter of interest to docrose@bellsouth.net.
ASSOCIATE POSITION – OH
Join our thriving practice of 3 podiatrists in the fastest growing county in Ohio (Delaware located north of Columbus). We are looking for a motivated, personable, caring doctor with solid training who wants to work in a positive environment and enjoys our profession every day! Contact footandanklewellnesscenter@gmail.com
ASSOCIATE POSITION - NORTHERN NEW JERSEY
Position available leading to buy in after 6-12 months for the right person. Well established practice all aspects of care. Modern facility and latest technology. Need a self-starter ambitious person to work and grow the practice. Send Resume and cover letter to DRFOOT44@gmail.com
ASSOCIATE POSITION – SAN FRANCISCO, CA
Immediate associate position available. Applicant should be personal, self-motivated and independent. Will provide diabetic treatments, biomechanical exams, minor office procedures, major surgical corrections, in-home care. Great surgical growth potential. Competitive compensation package. Send letter of intent and CV to: admin@blaskodpm.com.
ASSOCIATE POSITION - UPSTATE SC
Well-established three doctor practice seeks PSR-24/36 trained associate. New office building with privileges at nearby hospital and surgical center. EMR in place. Located near lake and mountains. Two hours from Charlotte and Atlanta. Please send letter of interest to docrose@bellsouth.net.
FULL-TIME ASSOCIATE - BRONX, NY
Associate needed for 30+ year busy private practice. Applicant should be personal, independent and motivated. Bilingual a plus. Practice entails all aspects of podiatry. Surgery, orthopedics, wound care, primary care and sports medicine. Competitive compensation package. Partnership opportunity for the right person. To apply please email letter of intent and CV to Bronxfootspecialist@gmail.com
ASSOCIATE POSITION - CAPITAL DISTRICT (NY)
Associate position with option to purchase practice. Upstate NY, Capital District. Applicants require NYS podiatric license and Medicare # ,Board certified or qualified. Position available immediately. Salary negotiable. Send CV and inquiries to: Gopodiatry@gmail.com
PM News Classified Ads Reach over 15,500 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 15,500 DPMs. for details, click here or write to: bblock@podiatrym.com 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.
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