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Serving Over 13,500 Podiatrists Daily

April 18, 2012 #4,439 Publisher-Barry Block, DPM, JD

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We've just mailed the April/May 2012 issue of Podiatry Management. This 220-page issue includes our cover story, "Podiatry in The  Digital Age", and a special section of articles on this topic, as well as an assortment of features, including our informative columns, and a CPME-approved CME.

April 2012 Podiatry Management

Gradually Increase Your Level of Exercise Over Time: IN Podiatrist

"Twenty-five percent of the bones in your body are in your feet, so it's complicated," Dr. John Rachoy, a local podiatrist who practices at the office of Medical Specialists in Munster and Schererville, said. "Most foot pain is caused by injury or improperly fit shoes. Both of these can be issues for people who are just starting to enjoy the great outdoors again for walking, hiking and/or running."

Dr. John Rachoy

"It's important that you are not always doing the same things in the same order," he said. "Stretching, before and after every workout, is also a key component to avoiding injuries. But, probably the most important thing for everyone to do is to gradually increase their exercise level over time."

Source: NWI Times [4/16/12]

UK Podiatrists to Train Indian Physicians in Diabetic Foot Care

Stuart Baird and Christine Skinner, both podiatrists, from Scotland's Glasgow Caledonian University (GCU), are visiting Trivandrum and Calicut to train 140 physicians in diabetic foot care on April 17 at the Institute of Palliative Medicine, Calicut.

Stuart Baird

"In India the role of the specialist podiatrist is undertaken by physicians. This program builds on physicians' knowledge and provides skills required to manage this challenging group of patients," says Stuart Baird, head, podiatric medicine and surgery, GCU. Baird and Skinner, previously World Health Organisation (WHO) consultants in diabetic foot disease, will demonstrate how to assess and manage complications.

Source: The Times of India [4/16/12]

NBPME Announces New Executive Director

The National Board of Podiatric Medical Examiners (NBPME) has announced that it has selected Phil Park of State College, PA to succeed Charles W. Gibley, Jr., PhD when he retires as Executive Director. The choice was announced by Stephen F. Stern, DPM, President of the Board.

Phil Park

“We are fortunate to have a person with a broad background in business and professional licensing as well as a deep appreciation for the podiatric profession from working with the podiatric licensing examination dating back to 1985,” said Dr. Mindy Benton, Chair of the Succession Committee.

NC Podiatrist Speaks at Aesthetic Show

Daniel Waldman, DPM spoke at The Aesthetic Show in Las Vegas on April 14, 2012. The Aesthetic Show is designed to bring all new aesthetic procedures, products, and technologies together in a condensed venue. This unique show includes introduction of the hottest new procedures related to the science of rejuvenation.

Dr. Daniel Waldman

Waldman's topic was laser treatment for toenail fungus. His lecture was well-received and elicited much interest and discussion from non- podiatrists. He is a member of the Council for Nail Disorders.

Deadline Extended for Appealing Medicare EHR Bonus

Physicians who believe they were incorrectly denied a Medicare bonus for using an electronic health record (EHR) system last year have a few more weeks to appeal their case. Earlier this month, the Centers for Medicare and Medicaid Services (CMS) announced that it is extending the deadline for such eligibility appeals from March 31 to April 30.

The new deadline of April 30 for eligibility appeals applies only to EHR bonuses under Medicare. In an eligibility appeal, clinicians must demonstrate that they met all the requirements of the Medicare EHR incentive program, but failed to receive a payment due to circumstances beyond their control.

Source: Robert Lowes, Medscape News [4/13/12]

Query: Removal of Screw

We have a patient who will be having a screw removed from her left first metatarsal. What would be the CPT code used for the procedure and what would be the diagnosis code? Would the screw be considered a foreign body?

Kathy Jagger, Office of Mark Goldberg, DPM, Chestertown, MD

Response: The screw is not considered a foreign body. It was purposely placed as part of the surgical procedure. I am assuming the screw needed removal because it was causing pain. If that is the case, then I would recommend

CPT 20680 - removal of buried deep hardware
ICD-9 729.5 - pain in limb

Vince Marino, DPM, San Francisco, CA

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Excisional Biospy (Joe Borden, DPM)
From: JP McAleer, DPM

I recommend a punch biopsy containing both healthy and pathologic tissues. The punch biopsy will provide you with a diagnosis which you can work with. If the tissue comes back malignant, send the patient to an oncological surgeon for more definitive care. If it is found to be benign, then it can be managed and resected completely with appropriate margins.

Another option would be to perform an incisional biopsy with frozen sections. If a malignancy is noted, the tissues can be cauterized and approximated to avoid seeding cancer cells into the general circulation. Both of these options are better than initially attempting a complete excision, especially in the case of a potential cancer.

JP McAleer, DPM, Jefferson City, MO, jpmcaleer@gmail.com

RE: 2013 eRx Hardship Exemption Link
From: George Jacobson, DPM

This is the link that will take you to the 2013 eRx hardship form.  After completion of the form, you should receive a confirmatory email.  If not, resubmit it. This has to done each year, when your previous year's exemption expires. 

George Jacobson, DPM, Hollywood, FL, fl1sun@msn.com>

RE: Urgent Care Clinics (Elliot Udell, DPM)
From: Bret Ribotsky, DPM

After reading Dr. Udell's post on PM News, I think he said that he liked "doc in the box" medicine. While I'll agree that for a cold, etc. while out of town, you can be helped from a "doc in the box". I worry about the masses of patients who are getting treated at these places by a nurse practitioner who has received a PhD, and is being called DOCTOR. 

I am sure you would love to see the foot doctor in the back of the drug store (Boot's pharmacies in London has these). Personally, I want only the best care for me and my family, not Wal-Mart medicine.  I am not inferring that Wal-Mart medicine is not just fine, but, I am sure we can all agree that today, when you think of a great medical centers and great physicians, the names, Wal-Mart, Target, K-mart, Sears, and JC Penny's are not on the top of your tongue.  

The great strides in America have come from the capitalistic system. Work hard and you can command a good fee for what you produce. If medical care gets relegated to a shift job, quality can only go down.

Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

RE: Code for Adjusting a Brace (Allen Sater, DPM)
From: Michael Hames, DPM

The Don Joy Velocity brace does not have a PDAC for L1971. Although the patient did buy this brace online, I would caution providers to check the braces they dispense with the Medicare DME site for accurate coding to limit liability in regards to an audit. The site for this is dmepdac.com/dmecsapp/do/search

Michael Hames, DPM, Florence, AL, hamesfootclinic@yahoo.com

RE: OH Podiatrist Discusses Celebrity's Neuroma
From: Steven Block, DPM

I've been waiting to see if there was much discussion about the claim of Steven Tyler's foot deformity being the result of a neuroma. 

Steven Tyler's Foot

Are there really pods out there who think this is from a neuroma? I must be missing something.
 
Steven Block, DPM, Owensboro, KY, sqrblk@live.com

PODIATRIC SPORTS MEDICINE FELLOWSHIP - ORANGE COUNTY CA

July 1, 2012 and ending July 31, 2013 (13 months). Responsibilities include assisting in all types of foot and ankle surgery, (approx. 500 cases), office and outside rotations including Sports Medicine Orthopedics Family Medicine, Biomechanics and Physical Therapy. Benefits include salary of $60,000/year, medical, dental, malpractice, and CME allowance. APPLICANTS MUST BE ABLE TO OBTAIN A CALIFORNIA LICENSE. Min. 24-month surgical residency training is a pre-requisite. Letter of interest, and CV to: Philip Radovic, DPM, Fellowship Director, 665 Camino de los Mares Suite 304, San Clemente, Ca. 92673. Ph: 949/493-8020 Fax: 949-488-0868. Email: Info@feetfixer.com.

MIDTOWN MANHATTAN OFFICE SPACE AVAILABLE

Office space available Wednesdays & Fridays (possibly Saturdays) on 46th & Madison. 2 Exam Rooms + Reception Space. Share with General MDs, Chiropractor & PT's. Potential for cross referrals. Downtown space at Fulton & Nassau also available on Thursdays. Call Kathy @ 646-483-1337 for more details.

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Be an owner not a worker. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Texas, Colorado, Wisconsin, Indiana, and Oklahoma. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305.www.aggeus.org

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances.  Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITION - SENIOR CARE DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: Immediate openings for physicians who are interested in caring for the elderly in nursing homes throughout Georgia. Full time position. Excellent salary, benefits, and opportunity for growth. Must understand the coding/billing process and have excellent documentation skills. You don't have to be board certified in foot or ankle surgery for this position. If interested, please contact Dr. Helfman at dhelfman@vpcenters.com

ASSOCIATE POSITION - ATLANTA, GEORGIA AND SURROUNDING COUNTIES

Village Podiatry Centers, LLC: Immediate openings for board eligible or certified, 3-4 year trained surgical physicians. Equity based model, Excellent salary and benefits to start depending on qualifications. (Average physician salary is 2-3 times industry median salary).Full benefits included. Access to practice owned surgery centers, pathology lab, imaging center(s), and other in house ancillaries. Very selective process: must be flexible, well trained, and must participate in our "Physician Training Program." You live off income and retire off wealth! Serious inquiries only! E-mail: David N. Helfman, DPM, FACFAS at dhelfman@vpcenters.com

PHYSICIAN FOR CLINICAL RESEARCH DIVISION - ATLANTA, GEORGIA

Village Podiatry Centers, LLC: If you have experience in running clinical research trials and would like a full time position in managing and overseeing multiple clinical research trials for our growing group, please contact Dr. Helfman @ dhelfman@vpcenters.com. Excellent salary, benefits and equity opportunity for the right individual. 

ASSOCIATE POSITION - TENNESSEE/NORTH GEORGIA

Multi-physician, Multi-office practice looking for motivated new associate leading to partnership. We are a busy practice with state of the art technology: EHR, Digital X-ray, Diagnostic Ultrasound, PADnet, EPAT machine. Applicant should be PMS 36/Board Qualified/Certified. Applicant should be ethical, personable, hard working and interested in providing all aspects of podiatric care to our patients. Competitive Salary and benefits. All interested candidates please send a CV with two letters of reference tomybestnewjob@gmail.com

ASSOCIATE POSITION – VIRGINIA

Two office practice, hospital and surgery center privileges, trauma call, modern offices, EHR, digital x-rays. Excellent compensation package. Position may lead to partnership. Candidate needs to be experienced in foot and ankle reconstruction and trauma. Email letter of interest and CV to Dr. Joe Disabato at jdisabato@vfasa.com

PRACTICE FOR SALE - AUSTIN TEXAS

Great opportunity for new practitioner or an additional office. 18 year practice with large patient base. Current physician transitioning to part time then retiring to pursue another business opportunity. Start turn-key without need for a bank loan. Great area to live and work. Susieintx@aol.com (512) 565-6634

PRACTICE FOR SALE - SOUTH NEW JERSEY

Great practice for sale, lease it, work in practice, rent-free first year, associateship possible. Must have NJ licensure have own TIN participation for Horizon, Cigna, Aetna, etc. Retiring. Anyone is welcome to make offer or come up with other ideas. Contact footcare@comcast.net

ASSOCIATE POSITION - PART TIME - OCEAN COUNTY, NEW JERSEY

Looking for PSR 24/36, board eligible preferred. Busy podiatric practice with up to date EMR & practice management program. Practice currently offers digital x-rays, ultrasounds, vascular studies and laser treatment. Good mix of general podiatry, wound care and surgery. Must be ethical, hardworking and committed to quality patient care. NJ license needed. Competitive salary and benefits. Send cover letter and resume to: AOKNDPM@gmail.com

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