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| PM News | |
The Voice of Podiatrists
Serving Over 18,450 Subscribers Daily
May 30, 2019 #6,429  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2019- 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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Are clinical practice guidelines beneficial or detrimental to the way you practice?
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| PODIATRISTS IN THE NEWS | |
IL Podiatrist Discusses Treatment of Onychomycosis
Getting rid of established toenail fungus can be difficult. Successfully eliminating it depends on careful adherence to a treatment plan. "What happens over time is that the fungus breeds in the nail tissue and goes from being just a little bit on the nail, to a really discolored and thickened nail, to a nail that is totally embedded with fungus," explains Marlene Reid, DPM, a doctor of podiatric medicine in Naperville, IL, and a spokesperson for the American Podiatric Medical Association.
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Dr. Marlene Reid |
How a toenail fungal infection is treated may depend on its severity. In white superficial onychomycosis, for example, the white patches of fungus that form on the nails can sometimes simply be filed off and an over-the-counter antifungal topical medication can be applied to the nail to kill the fungus. The symptoms of more severe infections include thickened, discolored toenails that may eventually become painful. In these situations, you should see a podiatrist who can devise a treatment plan that may include debridement, topical or oral medication, or even nail removal.
Source: Jeff Muise, Everyday Health [5/23/19]
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| PODIATRISTS IN THE MEDIA | |
OR Podiatrist Featured on Portland's KATU AM Northwest
Ellen Wenzel, DPM of Vancouver, WA was recently featured locally on Portland's AM Northwest program. She had the opportunity to speak about ankle and foot issues with host Tammy Hernandez.
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(L-R) Tammy Hernandez and Dr. Ellen Wenzel |
Dr. Wenzel is the managing partner of Ankle and Foot Physicians and Surgeons, PLLC which serves the Greater Portland Metropolitan area.
Source: KATU-TV
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
How to Renegotiate Payer Contracts - Part 2
If you feel stuck in a lousy deal with your payers, you can renegotiate. Here are some steps to renegotiate your contracts and improve your revenue.
2. Know your fee schedule - Anticipate that each payer will establish speed bumps to slow down your claims process. Some payers might require different procedures to submit claims, such as the use of a web portal, special emails, and the like. They will use vague language to give them wiggle room—and the opportunity to deny claims. Beat them at their own game. Create another database for your most common codes separated by each provider. Note how each code should be submitted. Make sure you capture all of them. Building this central repository will require time upfront, but it should ultimately speed up the daily claims process, reduce the number of days bills are in accounts receivable/accounts payable, lower the volume of denied claims, and make it easier should you resubmit.
Source: David J. Norris, MD, MBA, CPE, Physicians Practice [5/7/19]
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| CODINGLINE CORNER |
Query: Excision of a Callus
I recently had a patient with a hammertoe who insisted that she did not want any bone removed. She only wanted the overlying calluses removed. Putting aside the fact that the callus will most likely return (I warned her of this several times), how would one code this?
PM News subscriber
Response: Trimming a callus is billed as CPT 11055. For Medicare patients, there would need to be an associated risk factor (e.g. diabetes, etc.) or pain with ambulation. Other carriers would have their own rules. So the callus care may or may not be covered now or in the future as routine care may not be covered. This would be a cash service to you.
You could bill an E/M service ONCE since you evaluated the patient for the hammertoe and discussed possible treatment options. Beyond that, it would be a cash service to you.
Tony Poggio, DPM, Alameda, CA
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS (CLINICAL) | |
From: Allen Jacobs, DPM
The question of DVT and which patients require prophylaxis remains difficult to answer. Thrombo-embolic disease is of course a potentially catastrophic event. When it occurs, it is very easy to begin listing factors that would predispose the majority of patients whom we treat as at "increased risk" for DVT, thus raising the question of prophylaxis. There is no evidence that decreased venous flow associated with the use of a knee walker is associated with increased risk of thrombo-embolic disease. Decreased venous flow is associated with many factors, from general anesthesia to gout to decreased weight-bearing following an injury.
Furthermore, studies such as that cited by Dr. Ritchie did not demonstrate increased incidence of thrombus formation with the use of a knee walker. The clinical significance of decreased venous flow with a knee walker remains uncertain with regard to DVT and pulmonary embolism. Most venous thrombi following foot surgery are small, and are of little or no clinical significance. Any objective review of recent literature indicates that the incidence of thrombo-embolism associated with foot and ankle surgery is extraordinarily low. It has been suggested that it would be necessary to prophylaxis 10,000 patients to prevent one fatal PE following foot and ankle surgery. As with all patients, evaluation for risk factors for thrombo-embolism is appropriate. However, let’s not suggest that a knee walker is a causal factor for thrombo-embolic disease.
Allen Jacobs, DPM, St. Louis, MO
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| RESPONSES/COMMENTS (PM ARTICLES) | |
From: Burton J. Katzen, DPM
To my good friend Dr. Jacobs, let me ask... What are possible causes and treatment options of non-circulatory, non-fungal, non-medical dystrophic nails? Would antifungals or laser treatment improve the outcome? Even assuming a positive culture, doesn't any type of infection need a portal of entry? If a patient has bilateral hallux fungus nails with a positive culture, can any type of infection travel though a sock and shoe on one foot and through a shoe and sock on the other foot? Therefore, shouldn't we look a little further into possible etiology, such as repetitive trauma and other adjunct treatment options?
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Pre- and post-op photos |
Anyway, above is a case of a patient who 4-5 years ago had two courses of oral medication and two laser treatments with no results without a culture ever having been taken. The culture was negative and the only treatment was an extensor tenotomy distal to the hood and debridement in 3 months. I would be more than happy to provide you with hundreds of cases with similar results from this procedure.
Burton J. Katzen, DPM, Temple Hills, MD
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| RESPONSES/COMMENTS (CODINGLINE CORNER) | |
From: saorsa, Inc.
The topic of the billing of Swift treatments has been discussed recently in PM News and on Codingline.com. Given this speculation, we felt it important that we set the record straight. As such, this message is intended to remove any confusion around the applicability of billing codes for Swift treatment.
As a major part of the launch of Swift in the United States, we undertook exhaustive reviews of the current billing code options relevant to the treatment of warts including seeking the input of the top opinion leaders in the industry, coding experts, and also legal counsel. The ultimate and unanimous conclusion that we reached was that Swift immune therapy simply does not meet the criteria required when making an appropriate claim using billing code 17110 "destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions".
The Swift HPV protocol triggers an immune response by using 6-8W of power for 2 seconds raising cell temperatures to just 43-46 degrees C. The method of action is non-destructive; therefore, coding this procedure as 17110 would be a misrepresentation of the treatment delivered. All further discussion regarding how the system stimulates an immune response, the science behind it, and other considerations, while interesting and very important to understanding the systems' efficacy, is not relevant to the billing question. We trust that this clarifies the situation and we thank everyone for their interest and input.
saorsa Inc - The Swift Team
Editor's note: This topic is now closed.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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| Just in time for summer - a ventilated shoe |
Source: Dennis Keyes via Virtual Shoe Museum
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $229 (less than $16 per CECH)
(Only $15 per credit) http://www.podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, VT, WV, and WI
Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
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| CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION – HAMPTON ROADS, VIRGINIA
Searching for a FT DPM for a growing 2 office location practice. Must be compassionate and able to provide general podiatry care, wound care and surgery. VA license and BQ/BC preferred. Base + Bonus, health and IRA. Please email sara.bouraee@gmail.com with subject HRFAS POD OPP
PODIATRIST POSITION – SOUTH CAROLINA
Work and live in one of the greatest states for outdoor fun and recreation. Centrally located 2 hours from the mountains and the ocean, well established practice of 21 years seeking an associate for its rapidly growing and expanding office. Must be board qualified/certified by ABFAS. Looking for someone with great people skills who is dedicated to putting in the effort to grow the practice. No traveling, no nursing homes. You must have SC podiatry license and next test date is June 1. Please send cover letter and CV to docdan@earthlink.net
ASSOCIATE POSITION AVAILABLE – NORTH CAROLINA
New associate position that can lead to partnership. We are a very busy practice providing care in both office and hospital settings. We are fully integrated in a large tertiary teaching hospital. We are located in the beautiful mountains of western North Carolina. Research opportunities are available. Applicant should be ethical, personable, hardworking, and committed to quality patient care. We are offering a competitive salary with bonus opportunities and a wide range of benefits. North Carolina license to practice is required for this position. All interested candidates should send a CV with 2 letters of reference to JCMOOREDPM@aol.com
MOBILE PODIATRIST NEEDED - NEW JERSEY
Well-established and fast growing House-call podiatry practice (www.homefootcareservices.com) is looking for Full-Time /Part time podiatrist to do home visits to home-bound patients in NJ. Email resume - Lana.Raginsky@homefootcareservices.com
ASSOCIATE POSITION - KENTUCKY
Associate positions open for well-trained, compassionate physician for busy central office in the beautiful Somerset/Lake Cumberland KY and in our Bowling Green location. Wide range of services to be offered with several ancillary services onsite. Generous base salary with incentive/full benefits and partnership opportunity. Email CV to: kypodjob@gmail.com
ASSOCIATE POSITION - SW GEORGIA
Looking for a FT podiatrist in an established busy practice in Southwest GA. Applicant must be BQ/BC. Applicant must be able to provide a full range of podiatry services including foot surgery. This is a great community for raising a family/fishing/hunting/etc. Please send all CV to admin@tfacllc.org
ASSOCIATE POSITION – ALABAMA
Love the beach? Busy, established practice located in a coastal community is looking for a full-time or part-time podiatrist! ABFAS board qualification or certification is required. Must be motivated, hardworking, positive, and dedicated to growing the practice and individual career and reputation. Must have great people skills, caring bedside manner, and positive demeanor. Must work well with staff and local medical community. Competitive pay and partnership track available. Send CV and contact information to: manager@southbaldwinpodiatry.com
M NEWS CLASSIFIED ADS REACH OVER 18,000 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 18,000 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 davidekagan@gmail.com or call (215) 808-0770
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE – VISALIA CALIFORNIA
Extremely successful, well-established solo practice grossing $850K for the past six years. Doctor is relocating and ready to leave everything in place, including the fully functioning staff. Accepts all major insurances, Hospital and Surgical Center privileges. Serious inquiries only toptenpodiatrist@gmail.com
PRACTICE FOR SALE - JACKSON HEIGHTS, NY
Well established 27 year old practice. Turn-key operation. Great opportunity for established or new graduate. Excellent income potential on/off the insurance plans. Busy walk in traffic. 1100 square foot office in multi-specialty building. Email: gping1@yahoo.com
PRACTICE FOR SALE - EAST CENTRAL ILLINOIS
30 year established surgical practice East Central Illinois. Re-locating. Turn-key operation with 3 treatment rooms and surgical suite. Certified EHR. Generates $450K, price reduced to $250K (includes real estate currently listed for $150K with a local agent ). Call 217-549-1887 or email drjoe@myfeethurt.net
PRACTICE FOR SALE - EAST BAY OF SAN FRANCISCO
Energetic practice with completely updated technology and ready made patient base. Owner looking to relocate out-of-state. - Full service practice with ancillary services. Practice operated on a part-time basis. Employment option available. Priced to sell. Contact MCrosby518@gmail.com
PRACTICE FOR SALE - OKLAHOMA - OKC
Opportunity to buy a growing and rebuilt practice. Owner looking to downsize. Operated on a part-time basis with growing demand. Priced to sell. Turn-key operation. Contact MCrosby518@gmail.com
PRACTICE FOR SALE - CORPUS CHRISTI, TX
Well established 30 year podiatry practice on the Coast of Texas. Busy practice with low overhead not far from large medical complex. Excellent growth potential with large active patient base. Large physician and patient referral base. Family practice residents rotate through office. Email jrgouin@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 18,000 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 18,000 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 davidekagan@gmail.com or call (215) 808-0770.
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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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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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