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PM News

The Voice of Podiatrists

Serving Over 20,000 Subscribers Daily


May 04, 2021 #6,942 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2021- No part of PM News can be reproduced without the
written permission of Barry Block

PM NEWS QUICK POLL
Should podiatrists have the opportunity to train to be Mohs surgeons?
 
richieapr2621

PODIATRISTS IN THE NEWS
NY Podiatrist Discusses Best OTC Antifungals
 
According to New York City-based podiatrist Nelya Lobkova, DPM at Step Up Footcare, “Athlete's foot is a fungal infection in the skin. Like most fungal infections, fungus prefers a moist and dark environment. Thus it is important to keep the feet and the surfaces touching the feet clean and dry.”
 
Dr. Nelya Lobkova
 
Dr. Lobkova continues, “The best over-the-counter topical medications are derived from the allylamine family, such as topical terbinafine, because they are fungicidal and actually kill the fungus. Topical azoles, like clotrimazole, are fungistatic, meaning they limit fungal growth but they do not completely get rid of the athlete's foot." As you shop, keep an eye out for creams that are formulated with terbinafine and clotrimazole to eliminate or reduce athlete’s foot.
 
Source: Elizabeth Enochs, Enochs, Bustle [5/1/21]
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Gordonfeb2519B

PODIATRISTS AND SPORTS MEDICINE
Physical Therapy After the First Ankle Sprain is Critical: IN Podiatrist 
 
“Physical therapy after the first ankle sprain is critical,” said Robert Clemency, DPM, a podiatrist with Community Care Network in Schererville and Munster. “What therapy will do, it prevents re-occurrence by increasing strength about the joint as well as increasing or re-establishing some of those proprioceptive channels (nerves which tell the brain the posture of the joint) that are disrupted in the initial injury. So therapy is a means of preventing re-injury whether you are an athlete or a laborer. It’s critical in keeping the rate of re-occurrence low and having a better functional outcome after the first sprain.”
 
Dr. Robert Clemency
 
Nonetheless, many primary care providers are apparently reluctant to refer their patients with ankle sprains to physical therapy. According to research cited in the Journal of Orthopedic and Sports Physical Therapy, “Of patients who do seek care, only 6.8% to 11.0% are referred to a rehabilitation specialist within 30 days of the injury.”
 
Source: John Doherty, Northwest Indiana Times [5/1/21]
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PODIATRISTS IN THE COMMUNITY
Sanford Health Welcomes MN Podiatrist
 
Sanford Health of Northern Minnesota welcomes Tyler Zinnecker, DPM, to the podiatry team at the Sanford Bemidji Orthopedics and Sports Medicine Center. Dr. Zinnecker received his podiatric medical degree from the Des Moines University College of Podiatric Medicine in Des Moines, IA. Dr. Zinnecker gained additional experience during his residency at the Truman Medical Center Lakewood in Kansas City, MO.
 
Dr. Tyler Zinnecker
 
Prior to joining Sanford Health, Dr. Zinnecker practiced podiatric medicine at the Family Foot and Ankle Clinic in Weston, WI. He is certified by the American Board of Podiatric Medicine.
 
Source: The Bemidji Pioneer [5/1/21]
MTImar121

OUTSIDE INTERESTS
CA Podiatrist Set to Exhibit Art Tribute to His Former Partner 
 
Artist Don Hershman, DPM is set to exhibit his latest collection of original pieces as part of a retrospective series inspired by the late Victor Arimondi. In the spring show, Donald and Victor: Under The Influence, the inventive artist will embody his visceral need to pursue interests and creative expressions as he pays loving tribute to his former partner, who succumbed to AIDS in 2001.
 
Dr. Don Hershman
 
Dr. Hershman graduated from the California College of Podiatric Medicine in San Francisco, where he established a private practice in the early 1980s. As the painter was building his medical practice, he was also evolving a body of artwork, exploring various media in drawings and paintings, and finding his voice as an artist.
 
Source: Elizabeth Darwen, New York Lifestyles Magazine [May 2021]
medlinemay321

PRACTICE MANAGEMENT TIP OF THE DAY
Technologies Practices are Leveraging to Deliver Better Patient Care - Part 1
 
Here are technologies and their importance for practices in today's care delivery system.
 
1. Telehealth 
 
Telehealth has emerged as a delivery method largely embraced by patients, physicians, payers, and the federal government because it is an efficient and effective means of providing care that does not require an in-person visit. Now that so many more patients have experienced telehealth and gained first-hand appreciation for its benefits, the demand is expected to remain high well past the end of the pandemic. For practices with an existing telehealth program or those thinking about launching a program, careful attention must be paid to the technology used to support the program. Ensure any platforms and vendors are compliant with HIPAA under existing regulatory waivers and after those waivers expire.
 
Source: Nelson Gomes, Physicians Practice [4/29/21]
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picamar2921

CODINGLINE CORNER
Query: E/M and CPT Code on New Patient Encounters
 
When billing for new patient encounters, should and can you bill both the E/M and surgery CPT code?  An example could be a new patient encounter for an ingrown toenail comes to the office and a procedure is warranted. Would I bill CPT 9920x and CPT 11730 for partial nail avulsion? Should I only be coding for one? Would you suggest using a -25 modifier?
 
PM News Subscriber
 
Response: This is certainly a widely debated topic regarding E/M and surgical codes billed on the same date. Certainly, the answer is largely dependent on your documentation, in particular, for a new patient you have never seen before.
 
In order to bill for both, you need to take a history and have performed an examination in order to come to a conclusion, leading to a medical decision to avulse the toenail. If this was done, then it seems to meet the litmus test of an E/M service, for a new patient. The CPT 992XX must be amended with a -25 modifier, even if for the same diagnosis on an initial examination. As for the CPT 11730, it does not matter whether you avulse one border, two borders or the entire nail plate, only one unit of CPT 11730 can be billed.
 
Paul Kesselman, DPM, Woodside, NY
 
For information on Codingline subscriptions, click here
biancoinstrumentsjan1821

QUERIES (NON-CLINICAL)
Query: Source for Dehydrated Alcohol
 
I am looking for sources to purchase the dehydrated alcohol that is used as a sclerosing agent for neuromas. Currently, we purchase 5ml vials for about $250/ bottle. Their price is going up at the end of year to $800-$900 per bottle. 
 
Ed DosRemedios, DPM, Providence, RI
PCCmar2221

RESPONSES/COMMENTS (RELEVANT RESEARCH) - PART 1
From: Keith L. Gurnick, DPM
 
Avulsion fractures of the 5th metatarsal base are not the equivalent to a Jones fracture and are not treated in the same manner. The article does not equate an avulsion fracture with a Jones fracture, and I would hope that any PM News reader would not infer from the reference to the article or after reading the article that a Jones fracture should be treated with a hard sole shoe and you will get the same outcome, because you will not. The classification for proximal 5th metatarsal fractures are divided into three zones each with their prospective management and potential complications.  
 
Keith L. Gurnick, DPM, Los Angeles, CA
tetradec720A

RESPONSES/COMMENTS (RELEVANT RESEARCH) - PART 2A
From: Clifford Wolf, DPM
 
Dr. Levy's suggestion, "the manufacturer that makes the materials to perform Mohs surgery be contacted (e.g., Henry Schein Medical). Perhaps they may also have the resources to train or arrange for the training of DPMs interested in becoming proficient in this now commonly performed procedure. The profession should make whatever arrangements are needed for DPMs to acquire the required skill set for this potentially invaluable procedure." This made me laugh.
 
Dr. Markinson said, "Therefore when Dr. Levy asserts that DPMs 'should not be denied the opportunity to acquire the knowledge, skills, and training to perform Mohs surgery,' he is doing nothing more than cheerleading..." However, I love this cheerleading. It has led us to this discussion.
 
Dr. Levy believes "podiatric medical education and training will become more and more complex as medical science continues to evolve. The difference between the podiatric physician of the 1950s and 1960s and those who will be entering the profession in the late two thousands will be dramatic, bringing much more complex medical and surgical care to patients and solving problems that were not solvable."  Podiatry... we are trending in the right direction.
 
Clifford Wolf, DPM, Oceanside, CA
Astepbovejun1719

RESPONSES/COMMENTS (RELEVANT RESEARCH) - PART 2B
From: David Secord, DPM
 
One of the items that hasn't been presented on the discussion of being trained in Mohs surgical techniques is who would write malpractice for you. I did two months rotation with one of the top orthopedic oncologists (Richard Schmidt) in the area, who is now with Cancer Centers of America, but was at Fox Chase when I knew him at The Graduate Hospital. He could tell that I was very interested in orthopedic oncology and offered to have me do the same fellowship as he if I wanted to extend my training past residency. When I looked into it, I discovered that no podiatric malpractice carrier would write a policy which would cover oncology surgeries.
 
Ignoring the fact that only a small number of orthopedic oncology cases occur below the knee and would likely end up in the hands of someone other than a DPM, I turned down the possible opportunity to be a fellowship-trained podiatrist in orthopedic oncology as the parchment and $4 would get you a regular coffee at Starbucks, as no one would cover my liability. Even if someone were allowed the chance to do a Mohs surgical fellowship, would that individual also not find malpractice coverage and end up not doing the procedures even if trained?
 
David Secord, DPM, McAllen, TX
2020apr1221A

YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoe of the Day

Served at a podiatric luncheon?

Source: Submitted by Pearl Herman

comfortfitmay321

MEETING NOTICES AND WEBINARS

weaveapr1921

IFAFmay321

talarapr2621

presentmay321B

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PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME

You can Earn up to 5Continuing Education Contact Hours (CECH) Online

Earn 15 CECH only $249 (less than $17 per CECH)

 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

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Choose any or ALL from 25+ CECH Category-1 articles posted

NY podiatrists whose licenses expire from 3/2/20-5/1/21 may take all credits online


CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS
ASSOCIATE POSITION/PRACTICE FOR SALE – NASSAU COUNTY, LONG ISLAND 
 
Part time associate to work needed, or part time associate willing to work one day steady per week. Will sell 500k gross practice for 200k with sale of home/ office. North shore, Nassau county, Long Island. Contact: bombbustr7@aol.com
 
ASSOCIATE POSITION - NYC 
 
Fast growing, multi-location practice in Manhattan, NY is looking for a motivated, driven practitioner to join our surgical, sports-medicine based practice.  Our full-time associates average $200k+ per year. If personable, motivated, well-trained, and driven to succeed, we would be delighted to discuss a position with you. We offer a strong compensation package including health benefits and a healthy pension. Please send a cover letter and cv to: footdocnyc@outlook.com 
 
ASSOCIATE POSITION - WESTERN NY  
 
Full time associate looking to live in Western New York. Low cost of living area with multiple city centers a short drive away. Great place to live and raise a family. Great prospect for experienced DPM as well as a new graduate who desires to be part of a team and ultimately wants to be a partner in private practice and transition to ownership. Senior doctor is happy and willing to mentor. Must be willing to merge into an already established protocol based office with state of the art facility and equipment. Practice includes all aspects of podiatry ranging from surgery to routine care. Yourpracticenow@gmail.com
 
ASSOCIATE POSITION  NASSAU COUNTY, NY 
 
Multiple office practice located in Nassau County, New York seeking motivated, energetic individual to become an Associate in Merrick and Westbury locations. Multi lingual a plus. Leading to partnership and eventual ownership of practices. Please email CV to dgrossman5@optimum.net.
 
ASSOCIATE POSITION - ALBUQUERQUE, NM 
 
Foot & Ankle Specialists of New Mexico has an exciting position open for a board qualified or board-certified foot and ankle surgeon to start in the fall of 2021. You can view our website at footanklenm.com. Spanish speaking and Fellowship is a plus but not a requirement. Billing/coding experience is preferred. Compensation is a competitive salary plus a percentage bonus structure to start. Please email CV and cover letter to sswrege@yahoo.com.
 
ASSOCIATE POSITION - PISCATAWAY/HILLSBOROUGH, NJ 
 
We are a busy podiatry office with locations in Piscataway and Hillsborough, NJ. The office has been in practice for over 31 years and has great reputations. We are looking for motivated and driven full-time and part-time doctors. Candidate will be comfortable meeting doctors and business owners to build referral relationships. We will provide you with every tool needed for your success- treatment protocols, peer networking groups, and a full-time marketing person. drwishnie@stopfootpainfast.com  
 
ASSOCIATE POSITION - CHICAGO
 
Available immediately. Home visits/ some facilities/ some office hours . Illinois license is required. Existing patients’ base. Net $250-325K. logistics are provided. Full- and part-time are available. Contact vadim.goshko@gmail.com or 312-375-6430.
 
RESIDENCY POSITION - BOSTON MEDICAL CENTER 
 
News Flash as Boston Medical Center is granted an additional RRA position (PGY-1) for the upcoming 2021-2022 year. Could you be the next RRA resident at BMC? Please send most recent CASPR application or similar to Winnie Chen via email winnie.chen@bmc.org.
 
PM NEWS CLASSIFIED  ADS REACH OVER 20,000 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 20,000 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
CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE
OFFICE TO SHARE – MANHATTAN (MIDTOWN EAST)  
 
A podiatry office to share in a prime location near Grand Central. Located on the ground floor with direct street access (no doorman), the office was beautifully renovated in 2019 as a modern medical facility. It is 900 SF with 5 treatment rooms and currently has one DPM. We are looking for a full time, long-term lease but will consider other options. For additional information, please email: podiatryoffice25@gmail.com.
 
PRACTICE FOR SALE - SOUTHERN MASSACHUSETTS 
 
Est. practice with optimum visibility and referrals. 3.5 days/week; increase growth by adding hours. Great income potential for a foot surgeon. Hospital privileges available. Gross approx. $300,000. Priced at $170,000 includes equipment, turn-key. Email at dpmassist@gmail.com
 
PRACTICE FOR SALE - PALM BEACH COUNTY, FLORIDA 
 
Retiring. 40-year practice. Superb location, coastal Palm Beach County. Nonsurgical care, mostly geriatric. 4 exam rooms, 2 whirlpool rooms. Small surgical suite with x-ray.  Kitchen/lab area includes autoclave. One private office with restroom. Cannot give accurate income estimate due to 3-year illness+pandemic. lwp01@bellsouth.net or 561-586-3100.
 
PRACTICE FOR SALE - WHITE PLAINS, NY 
 
30 year old practice in growing development of White Plains for sale. Owner retiring from practice. Opportunity to purchase practice with established base. Full service practice with in office procedures and surgery center privileges. Strong new patient volume. Priced to sell with flexible terms. Contact: MCrosby518@gmail.com
 
PRACTICE FOR SALE - NORTH CENTRAL TEXAS 
 
Established, 35 plus years, growing practice for sale. General podiatry with large volume of wound care, diabetic foot care, and pediatric treatment. Hospital privileges close by. Strong referral base with great growth potential. Contact  cscjrlaw@gmail.com or 972-978-6691.
 
PRACTICE FOR SALE - WESTERN WASHINGTON STATE 
 
33 year old well-rounded surgical/non-surgical practice located north of Seattle, a five minute drive to the local hospital and surgery centers. The practice is blocks from the ocean with plenty of parking and includes a small in-office operatory with a mini C-arm. WApodoffice@gmail.com
 
PRACTICE FOR SALE – NEW JERSEY
 
15 min. from Philly; 38 y/o practice; all phases of podiatry office and hosp. surgery EMR, digital x-ray, great staff. Grosses 300 K in 2 1/2 days can easily expand to full time. Optional building purchase. Retiring but will stay as long as needed for transition. contact jay195322@gmail.com 
 
PM NEWS CLASSIFIED  ADS REACH OVER 20,000 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 20,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
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.
Guidelines
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  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
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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.

Barry H. Block, DPM, JD
 
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