The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 21, 2009 #3,499 Publisher-Barry Block, DPM, JD

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Dr. Jack Lawrence, 96

Dr. Jack Lawrence led a life as richly drawn and romantic as any of his hit songs. The prolific songwriter, who wrote songs into his 90s from his cozy and comfortable West Redding, CT home, told his story in a new book, “They All Sang My Songs.” Though he pursued songwriting with a passion, he obtained a podiatry degree in 1932 “just in case” and paid the $2 fee for his license to practice.

Dr. Jack Lawrence

Over the years, his songs helped launch or seal the careers of such greats as Frank Sinatra (“All or Nothing at All”), Bobby Darin (“Beyond the Sea”), Rosemary Clooney (“Tenderly”), and Dinah Shore (“Yes, My Darling Daughter”). Lawrence  received a Lifetime Achievement Award in 2004 from the American Society of Composers, Authors and Publishers (ASCAP).

Source: Andrea Valluzzo, News-TimeLive.com
 

Spring is the Season for Overuse Injuries to the Foot: NY Podiatrist

“As we increase our activities, we are prone to overuse injuries and other damage to the foot, says Dr. Paul Greenberg, a Manhattan podiatrist on staff at Roosevelt-St. Lukes hospital. “Among the common conditions we see are heel spur syndrome, plantar fasciitis, ankle sprains, stress fractures, and Achilles tendinitis.”

Dr. Paul Greenberg

According to Greenberg, “Heel spur syndrome comprises 15% of all foot injuries and is due to an inflammation of the plantar fascia ligament on the bottom of the foot. Self-treatment includes stretching of the calf, proper athletic shoes, and avoidance of flimsy shoes, such as flip-flops.

Greenberg says “in the springtime, as people also start to wear open-toed shoes, we see athletes foot and onychomycosis.”

Source: Dr. Tim Johnson, Good Morning America [3/11/09]
 

Foot Doctors Top List on AOL Most Searched List

Going to visit the doctor can be a nerve-racking experience. Even if you are just going for a check-up, you don't want them to discover any hidden health problems. And if you are experiencing health issues, you may be scared to hear the prognosis. Either way, you are lucky in the United States to be able to find a doctor who specializes in any health problem you may encounter. Take a look at our top searched list to see which types of doctors are most in demand.

The top searched doctor on our list must be in high demand from women. With high heels getting higher every year (I saw a 6" pair in stores this weekend!), it's no wonder everyone is looking for foot doctors.

Top Searched Doctors on AOL Search:
1. Foot doctor
2. Heart doctor
3. Dermatology doctor
4. Eye doctor
5. Orthopedic doctor
6. Diabetes doctor
7. Holistic doctor
8. Eye, ear, nose and throat doctor
9. Plastic surgery doctor
10. Thyroid doctor

Source: AOL Hot Searches via Dr. Robert Fridman
 

Healthcare Overhaul Cost May Reach $1.5 Trillion

Your lungs may work just fine, but the estimated price for universal health care could take your breath away. Health policy experts say guaranteeing coverage for all Americans may cost about $1.5 trillion over the next decade. That would be more than double the $634 billion 'down payment' President Barack Obama set aside for health reform in his budget. About 48 million people are uninsured, and the problem is only expected to get worse because the cost of coverage keeps rising.

Still, administration officials have pointedly avoided providing a ballpark estimate for Obama's fix, saying it depends on details to be worked out with Congress. "It's impossible to put a price tag on the plan before even the basics have been finalized," said White House spokesman Reid Cherlin. "Here's what we do know: The reserve fund in the president's budget is fully paid for and provides a substantial down payment on the cost of reforming our healthcare system."

Source: Ricardo Alonso-Zaldivar, Associated Press [3/18/09]

Query: Associate Compensation
From: David Zuckerman, DPM

I have a new associate who I am paying 40% commission (only what is collected) for patients he sees. He wants more than the 40% when he treats a patient from his old practice in my office. Any comments?

David Zuckerman, DPM, Woodbury, NJ

Query: I&D Tophi Coding

The doctor did an incision and drainage of abscessed tophi in the office. It was cultured. The ulcerated tophi extend nearly down to the level of bone. No sinus tracts were noted. All tophacious material and necrotic tissue was debrided.

I was thinking of using procedure code, CPT 10061 (incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; complicated or multiple) or possbily CPT 28002 (incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space). What is the best coding choice?

Laurie Bodo, Lake Orion, MI

Response: Presuming you are performing a debridement, I would recommend using the appropriate debridement code rather than an I&D procedure code. If the tissue was debrided "nearly to the bone", I recommend CPT 11043 (debridement of skin, subcutaneous and muscle/tendon).

This accurately identifies the work done.

Howard Zlotoff, DPM, Camp Hill, PA 

Codingline subscription information can be found at:
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RE: Use of Nerve Biopsy (Gerald Mauriello, Jr., DPM, MA)
From: Richard Mann, DPM

Biopsy of the sural nerve may lead to hypesthesia or dysesthesia to the distribution of the nerve. This is not surprising in that you are cutting a nerve. Biopsies to determine epidermal nerve fiber density can be used to diagnose small fiber neuropathy, as well as diabetic peripheral neuropathy, and are less likely to have these complications.  This test is available from Brad Bakotic's lab, Bako Labs.

Richard Mann, DPM, Delray Beach, FL, rhm123@gmail.com
 

RE: CAM Walker After Base Wedge Osteotomy (David Sands, DPM, Paul Kesselman, DPM)
From: Jonathan B. Purdy, DPM, Shari Lee, PMAC

A patient who has undergone a surgical correction for a bunion deformity through an osteotomy will have pain, swelling, and a fixated fracture. The CAM walker will be needed to immobilize, support, protect and assist in healing of surgical trauma and a fracture. To use any of these descriptors would not be dishonest and are perfectly factual. Does it indicate somewhere how a fracture must occur in order for this device to be covered?  
 
Jonathan B. Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com

This is normal practice in our office. I have never had an insurance deny the walker.  I bill L4360 Pneumatic Walker (Aircast) using the bunion diagnosis 727.1 & hallux valgus 735.0. Remember, if Medicare, you must submit to DMERC. A fracture code would not be needed nor correct. All insurance companies that I have billed have paid.

Shari Lee, PMAC, CLR-P, Midlands Podiatry, PA, midlandspodiatry@bellsouth.net

RE: Central Vacuum Attachment for Handpiece (Jeffrey Horowitz, DPM)
From: Richard Rettig, DPM

The attachment pictured was custom-made for a vendor of whole-office vacuum units. The vendor is out of business. You may consider an off-the-shelf wall attachment for whole-house vacuums, and use adaptor fittings to bring the size down to the hose utilized.
 
Richard Rettig, DPM, Philadelphia, PA,rich.rettig@verizon.net

PRACTICE FOR SALE - CENTRAL FL

Practice sale, in beautiful, high quality of life, growing area; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail: windnwave@earthlink.net

PRACTICE FOR SALE-SOUTHEAST MICHIGAN-BRIGHTON

Great opportunity. Established 11 years. Excellent location. Large illuminated sign on busy main road. Mid to high income growth area.  Supplies, furniture, and equipment included: X-Cell X-Ray w Hope Autoprocessor, Pelton-Crane Autoclave, Parks Lab, Bircher, Burton Floor Light, OR with Lighting, bone instruments and power equipment, Midmark Chairs. Quality 1,350 sf build-out. convenient parking. Must sacrifice. Call (248) 565-5266. Docpod@aol.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PRACTICE FOR SALE – FLORIDA 

Who wants to continue making good money in a down economy, and would like to live in Florida on the coast? I have been working for 45 years and have had enough. My business grosses over $900,000 a year and nets over S250,000. I see approx. 40 patients a day and am sitting on a little gem. Office space is approx. 2,000 Sq. Ft. Hospital surgical center very close. If you are seriously interested, I help you get  qualified for a loan. Large scope of practice in Florida. $525,000. Contact me at Hagen5644@yahoo.com 

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, ARIZONA

Seeking a well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call. Opportunity for partnership at 2 surgery centers. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing Machine. Excellent referral base, and a well-trained staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to FootAnkleAZ@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITIONS – CALIFORNIA

Three podiatrists needed for busy North Hollywood office. Full-time Monday-Friday 8am-2:30pm.  No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

LOOKING FOR FINANCIAL SECURITY?

Our practice continues to grow and we’re in search of a motivated, well-trained DPM who is great with patients. Our multi-office practice is located in the scenic Hudson Valley region of New York State. This is a great career opportunity for the right person(s), with an excellent compensation package available. Please reply to Hudson Valley Foot Associates, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com 

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