The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 27, 2011 #4,145 Publisher-Barry Block, DPM, JD

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MO Podiatrist Warns of the Dangers of Wearing Flip-Flops

Summer may be fun time; but it is also hard on your feet just by the very nature of summertime activities. Whether it be the cute new flip flops, the hot sand beneath your feet, the boat dock or even mowing the grass, some of the things we find ourselves doing during the summer months pose a risk to our feet if we are not careful. Dr. William Duke, JCMG Podiatry, said caution and care can help save your feet year round. Flip flops are the official footwear of summer. Some wear them from the first day of 70 degree weather until snowfall the next winter, but those cute and lightweight sandals really do not do anything good for your feet at all, Duke said. 

Dr. William Duke

"Flip flops really do nothing for your feet," Duke said. "I see a lot of problems because of flip flops. If you are on vacation or by the pool, it is not bad to occasionally wear them." Duke said he worries about the cleanliness of shoes that were first designed as shower shoes. Plantar fasciitis, tendinitis, other tendon issues, and even tired feeling feet can be a result of wearing flip flops long-term. "There is no support and you need support," Duke said. "We are most active during the summer, and that is when our feet need the most support."

Angie Hutschreider, Jefferson City News-Tribune (4/19/11)

RI Podiatrist Raises Money for Melanoma Research in Father's Memory

Dr. Jordan Sheff, a Barrington resident and podiatrist with offices in Newport, is donating co-payments his patients pay during the month of May to the Melanoma Research Foundation (MRF). May is melanoma awareness month. 

Dr. Jordan Sheff with photo of his father

"In an effort to help raise awareness as well as help raise money for research to cure this terrible disease, I plan to donate 100 percent of the co-pays collected in my office for the entire month of May to the Melanoma Research Foundation," Dr. Sheff said. Dr. Sheff recently lost his father Larry to melanoma.

Source: Joan Warren, EastBayRI.com [4/25/11]

Supreme Court Won't Fast-Track VA Reform Suit

The U.S. Supreme Court has declined to fast-track oral arguments in a lawsuit in which a Virginia federal judge struck down the Patient Protection and Affordable Care Act requirement that nearly all private individuals purchase health insurance.

Virginia Attorney General Kenneth Cuccinelli II had asked the U.S. Supreme Court to bypass the normal appeals process and take up oral arguments immediately in his case against the ACA. Although it was an extraordinary request, Cuccinelli argued that the high cost and far-reaching implications of the law augured in favor of a swift resolution. The Supreme Court issued a one-sentence denial Monday morning saying it was declining to grant Cuccinelli's “writ of certiorari before judgment” without elaborating on its reasoning.

Source: Joe Carlson, Modern Healthcare [4/25/11]

APMA Awards its Seal of Acceptance to Thera-Band

The American Podiatric Medical Association (APMA) has awarded the APMA Seal of Acceptance to the Thera-Band First Step to Foot Relief, a first-line treatment plan for heel pain. The seal is awarded to a product after the Committee on Podiatric Seals, a standing committee of the American Podiatric Medical Association, scientifically evaluates and determines whether the product allows normal foot function and promotes quality foot health.
 
The First Step to Foot Relief provides the podiatrist with an at-home treatment plan designed to enhance their in-clinic service with professional tools and an easy-to-follow program. The product was developed under the direction of practicing podiatrists, physical therapists, and chiropractors to address heel pain.

Source: Chiropractic Economics  [4/21/11]

RE: Podiatric Templates for EMR

Can anyone help me locate a podiatric template library? I am working on my new EMR system and podiatric templates would make for an easier transition. Any information would be appreciated.

Mark Lambert, DPM, Pensacola, FL

Query: Resconstruction of Superior Peroneal Retinaculum

I need help coding a reconstruction of superior peroneal retinaculum with repair of peroneal long and brevis tendon. From the op report: "The superior retinaculum was somewhat macerated with the laceration. It was then repaired with pants vest-type repair suture through bone of the posterolateral edge of the fibula."

I am thinking about CPT 27658 x2 (repair, flexor tendon, leg; primary, without graft, each tendon) for the two tendons, but was unsure if the other code would be unlisted.

Brigitte Rose, Grand Junction, CO

Response: I gather from your description that the peroneal tendons were repaired surgically - not specifically the anatomy that resulted in their dislocating - but it wasn't mentioned in the brief section of the operative report you shared.

If, indeed, the two peroneal tendons were repaired surgically, the code you mentioned, CPT 27658 - repair flexor tendon, without graft, each tendon - would be reasonable.

I think the retinaculum repair should be considered inclusive with the tendon repairs, and should not be billed separately.

Howard Zlotoff DPM, Camp Hill, PA

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RE: Post-op Nail Complication (Brent Rubin, DPM)
From: Lancing Malusky, DPM

Regarding post-phenol nail surgery weeping: ten years ago I had problems with prolonged drainage post-phenol. A colleague suggested that this seemed like a foreign body response. It turned out that the micro-tipped applicators had shed micro-shards of wood into our jar. We now always clean out the jar before re-sterilizing. Problem solved.

Lancing Malusky, DPM, Kettering, OH, lmalusky@woh.rr.com

RE: Amazing Charts (William H. FitzPatrick DPM, CPed)
From: Bob Kuvent, DPM, Jordan Sheff, DPM

I have used AC for a couple of years. It is very bare-bones, with limited flexibility and minimal reporting systems. Far and away, the worst attribute is the "integrated" MTBC billing company. Using MTBC was quite possibly the worst business decision I have made in 20 yrs. Buyer beware! 

Bob Kuvent, DPM, Chandler, AZ, FtFixr@gmail.com

I've been using Amazing Charts for 18 months now and could not say enough about it. For the price you pay, it is simply, well, amazing. Great customer support too, but be sure to buy their guardian angel protection plan.

Jordan Sheff, DPM,  Newport, RI, jsheff@newportfootcare.necoxmail.com

RE: Dexamethasone Substitute (Olga Luepschen, DPM)
From: David L. Nielson, DPM

We have switched to methylprednisinolone. It is just as efficacious and is less expensive. The  billing code is J1030 x units used (1 unit per ml)

David L. Nielson, DPM, Roanoke, VA, david.l.nielson@gmail.com

RE: Exogen Bone Healing System (Tip Sullivan, DPM)
From: Joe Quattrone, DPM

Despite the Exogen 4000 having a "fresh fracture" indication, realize that this is not an "induced fracture" as an osteotomy would be. If someone trips and falls and fractures their foot, particularly a metatarsal (825.25), there should be no problem having a private insurance or some MC secondaries cover this. My Smith and Nephew rep has never had an induced fracture or osteotomy covered by any carrier.

The other place I have had success with this unit is in chronically breaking medial cuneiforms or cuboids, where MRI definitively demonstrates breakdown of these cancellous bones usually exhibiting marrow edema. I have had two middle-aged women recently who have had significant trauma of their midfeet with chronic pain for nearly one year. Each responded extremely well to the Exogen 4000.

Joe Quattrone, DPM, Sebastian, FL,  docq1001@yahoo.com

RE: More Malapropisms
From: Martin R. Taubman, DPM, Mark Edmunds, DPM

A 75-year-old retired patient asked, "Doc, I can't get a reserection. What should I do?"  A 12-year-old patient's mother completed his registration form answering the question, "Have you had any surgical procedures?" thusly, "He had a ciss on his ass."

Martin R. Taubman, DPM, San Diego, CA

As part of a patient's past surgical history, he wrote down "testicles tied." I think he meant a vasectomy.

Mark Edmunds, DPM, Hopkinsville, KY

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.com.

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION – NEW JERSEY

Associate wanted full-time, for practice in East Orange NJ PSR 24-36 trained. Must be motivated to grow practice, especially build wound care and surgical services. Buy-in possible after the 1st year. send CV to Drfoot44@gmail.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

PODIATRIST NEEDED - NY/QUEENS/LI

Must be min. PSR-3 with excellent training. Experienced in billing, selling non-covered services, products, Patient medical and surgical exp. with good rapport/comm. skills necessary. Unique position working in offices, clinics, hospital with orthopedist, podiatrist, P. therapists. P/T, F/T available. Growth, income potential and partnership opportunity excellent. A chance to use all your skills; foot, ankle and more. Please respond with cover letter and CV to hansfeet@aol.com

EQUIPMENT FOR SALE - COOL TOUCH LASER

Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Also a used Lumix 2 laser, best price today. Dr. Zuckerman is in the Fort Lauderdale area and will demo these lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - NORTHWEST SUBURBS, CHICAGO, IL

Great Opportunity! Present owner to stay on for transition. Average 20% growth over 3 years while open only 4 half days a week. Excellent growth potential with increased hours. Perfect for a new practitioner or a 2nd location. contact podiatrynwsuburbs@gmail.com for information.

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. 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

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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

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