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| PM News | |
The Voice of Podiatrists
Serving Over 18,434 Subscribers Daily
June 11, 2020 #6,699  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2020- 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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Have you been tested for the coronavirus?
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| PODIATRISTS IN THE MEDIA | |
Summertime Means Increased Incidence of Heel Pain: IN Podiatrist
Summertime means shorts, t-shirts, and sandals. The warm weather may have you thinking about ditching comfort and stability for shoes with style. We spoke with a podiatrist who says constant foot pain should not be ignored. Taking care of your feet may be an afterthought, but if you’ve struggled with pain, you know how debilitating it can be. "The thing that I see frequently is heel pain," said Kevin Houseman, DPM with Goshen Health.
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Dr. Kevin Houseman |
Dr. Houseman sees all kinds of podiatry problems. He says summertime could result in heel inflammation. "It brings a lot of patients in, especially summertime they are going barefoot or wearing different shoes than they normally would wear. A lot of times, less supportive shoes." He says he starts with conservative treatment measures first. "Stretching, icing, custom insoles, footgear changes, injection therapy, or sometimes physical therapy is helpful for these patients. Ultimately, there is a certain amount of the population that might need surgery, but generally it’s not that common."
Source: Dayne Marae, WSBT [6/9/20]
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| PODIATRISTS IN THE NEWS | |
Inspect Your Feet Daily For Signs of Skin Cancer: DE Podiatrist
According to Claire Capobianco, DPM, "Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and they overlook applying sunscreen to the area. Skin cancer of the foot is prevalent and can even be fatal if not caught early. While all types of skin cancer, including squamous cell and basal cell carcinoma, can be found on the foot, the most common is the most serious form, melanoma. Symptoms can be as subtle as an abnormal-looking mole or freckle found anywhere on the foot, and often go unnoticed without routine foot exams.
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Dr. Claire Capobianco |
"Early diagnosis is key to effective treatment for the condition. But because people aren’t looking for the early warning signs or taking the same precautions they do for other areas of the body, skin cancer in this region often is missed entirely. Also, it is hard to see all the surfaces of one’s feet, even for flexible people. I advise my patients to regularly inspect their feet, including the soles, in between their toes and even under their toenails, for any changing moles or spots, and to have any suspicious areas promptly examined by a foot and ankle specialist," says Dr. Capobianco.
Source: Cape Gazette [6/9/20]
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| NOMINATIONS OPEN FOR PM FUTURE STARS | |
Nominations Open for 2021 PM Future Stars
In 2021, Podiatry Management Magazine will be publishing our continuing series highlighting young practitioners. We are asking our readers to nominate potential candidates who are making a difference. We invite you to send us the name of a young practitioner (graduated 2011 or later) and why s/he should be recognized. Self-nominations will be accepted. Simply write to bblock@podiatrym.com
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| RELEVANT RESEARCH - PART 1 | |
Study by NC and NY Podiatrists Compares MIS Bunion Surgeries
Don Peacock, DPM and Dieter Fellner, DPM recently published a Level 3 retrospective comparative study comparing two minimally invasive hallux valgus procedures. The study titled MIAA vs. SERI Minimally Invasive HAV Correction: A Retrospective Comparative Single Surgeon Study in a Rural Area represents the first peer-reviewed report that compares two minimally invasive hallux valgus procedures.
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(L-R) Drs. Don Peacock and Dieter Fellner |
The publication is presented in Clinical Research on Foot and Ankle. Conclusion: Both techniques obtained correction of mild to moderate hallux valgus with similar radiological measurement outcomes at six months. However, the minimally invasive Austin-Akin group had significantly less pain at six weeks
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| RELEVANT RESEARCH - PART 2 | |
Orthotics Breakthrough Helps Children with Cerebral Palsy Walk and Play
Children with cerebral palsy have more energy to play and be physically active for longer thanks to specially designed orthotics. Researchers have confirmed that adapting splints in combination with the footwear used by disabled children to help them walk can decrease the energy they use by as much as 33%. The clinical biomechanics team at Staffordshire University and the orthotics specialists from The Royal Wolverhampton NHS Trust examined the effectiveness of tuning the splint – footwear combination, using clinical trials with families in the West Midlands.
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AFOs Help Children with Cerebral Palsy |
During the study, the researchers analyzed the walking pattern of children with cerebral palsy at Staffordshire University’s specialist gait laboratory, and participants were assessed while barefoot and with both non-tuned and tuned splints. Children wearing the fine-tuned splints showed improvements in several areas including hip and pelvic function and knee extension, while a non-tuned splint potentially showed a decrease in hip function.
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
Five Things COVID is Teaching Us About The Patient Experience - Part 2
In the school of hard knocks, the coronavirus is the new headmaster. COVID-19 administered a nearly impossible financial test to physician practices, forcing them to quickly rethink the way they deliver care. With the arduous adjustments behind us, we can begin to make sense of its lessons. Here are five things COVID-19 is teaching us about the patient experience that will extend long past this pandemic:
2. Make it familiar. Virtual workflows should match the familiar steps of an in-office visit, but without the hassle of long waits and duplicated forms. Telehealth workflows that map to traditional clinical workflows—from waiting room to payment to intake to doctor’s visit—deliver a more natural, comfortable experience that patients prefer and expect, while allowing physicians and clinical staff to work efficiently and effectively.
Source: Scott Freedman, Physicians Practice [6/3/20]
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| CODINGLINE CORNER |
RE: Modifier -59 Versus XS
We are having issues billing CPT 11055 with CPT 11720 -59 modifier. Insurance companies Anthem Blue, MCR, and Optium UHC are denying CPT 11720 with -59 for the lesions as it is “not an appropriate modifier.” I was doing some more reading under global surgery modifiers. Should we be using the XS separate and distinct modifier instead? It is notated in the office: note the location and digit for the lesion removal, toe code, and if we are to using it for the lesions. Should we consider this modifier for all insurances in these scenarios?
Robert Rutstein, DPM, Hartford, CT
Response: CMS started the “X” modifiers on or after January 1, 2015 and payer by payer seems to allow their use. To your blanket question: “Should we consider this modifier for all insurances in these scenarios?”: my answer is "no". My qualifying statement is to check with the payer policy to see if they accept the X modifiers. Next, about billing CPTs 11720 and 11055. If they do not accept -59, then I suggest XS for UHC. Make sure the diagnosis matches their policy for coverage. I usually bill as an example the systemic diagnosis for coverage, i.e. E11.51/E11.42 or I73.9 and L84 as secondary to UHC for the CPT 11055. For CPT 11720, I usually bill the systemic diagnosis for coverage, i.e. E11.51/E11.42 or I73.9 and B35.1 as secondary to UHC.
David J Freedman, DPM, CPC, Silver Spring, MD
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS (CORONAVIRUS PANDEMIC) | |
RE: Kudos to APMA
From: Timothy P. Shea, DPM
Thank you Dr. Rubenstein, and staff of APMA for assisting members who have not received any funds from the HHS stimulus in the first round and now are excluded from any funds in the second round of stimulus money. As one of those practicing podiatrists who has remained open and retained staff during this COVID-19 crisis, and clearly is eligible for funding, I have gone through the gamut, trying to rectify this oversight.
The APMA through its directors and legal staff have assisted me in this effort. Unfortunately, the process by which the program was set up means there is no way to find out why you may have been denied. This is true even if you make it through the hotline process and it is clear you should be eligible. They cannot rectify it as they do not have the authority to distribute funds or change status. It is a Catch-22 at the highest level.
I am hopeful that HHS will take a hard look at the letter APMA has sent them, and also at eradicating the inequality of the current scenario. Thank you again APMA. It is another reason why all practicing podiatrists need to join.
Timothy P. Shea, DPM, Concord, CA
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A | |
From: Gregory T. Amarantos, DPM
Prior to MIPS, we had MeaningLESS use. Unless you are an epidemiologist employed by the government, there has been no value to the populace at large. It is a way for those in the ivory towers to penalize those sheep who refuse to be led to slaughter.
Gregory T. Amarantos, DPM, Glenview, IL
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B | |
From: Alan Bass, DPM
Let me begin by saying that this is my opinion only. In the last 25+ years of practice, I have seen some, if not most, of the governmental programs that have been rolled out by CMS. I understand that CMS has tried to reinvent how physicians practice medicine and guide them towards providing quality care. Even without this push from CMS, I believe that all physicians have tried to provide quality care to patients. Are there physicians out there who have tried to “beat the system”? Sure, but I believe that most physicians have always tried to do the right thing.
The MIPS system, as it currently is, and what it is morphing into in the coming years is about one thing, data gathering. It was the same thing with Meaningful Use. The Meaningful Use program was supposed to move physicians away from quantity and towards quality. Did it do that? Not at all. What did it do? All it did was...
Editor's Note: Dr. Bass' extended-length letter can read here
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2A | |
From: Charles Morelli, DPM
You asked to "detail your techniques for reducing toenail hypertrophy". It has nothing to do with technique and all to do with having sharp instruments. If, and only if, your instruments are sharp, can this be done relatively easily and without pain to the patient. A dull instrument will do a less than optimal job and be painful for the patient if you are trying to reduce nail thickness. That being said, I do grind nails, have used a vacuum extractor for the past 30 years, and I now also wear a mask and will continue doing so, long after COVID is gone. I'd be embarrassed to have some patients leave my office without my doing that, but that is just me, as I know others will disagree.
Charles Morelli, DPM, Mamaroneck, NY
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B | |
From: Elliot Udell, DPM
Thank you Dr. Markinson for once again reminding us of the non-COVID-19 risks associated with grinding toenails. Several responders have legitimately asked how to adequately soften nails so as to properly debride them without the use of an electrical drill.
As an allergy sufferer, I had to limit nail grinding very early in my career. I coughed and wheezed, even with the use of dust extractors. When papers came out showing that breathing in nail dust was an occupational hazard, I took all of the drills and extractors to the nearest dumpster. Some papers showed that the dust remains in the air for over 11 hours.
There are ways to soften nails so that they can be adequately debrided. Spraying the nails with "Three Way Solution", often works. Another way is to dispense some of the nail softening products and insist that the patients use them daily between visits. We get great results with Bako's 40% urea nail gel as well as other products such as Formula 7. We have found that if the patients use these as well as other urea containing nail products, there is no need to mourn the use of nail grinding devices.
Elliot Udell, DPM, Hicksville, NY
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| RESPONSES/COMMENTS (PM ARTICLES) | |
From: Kenneth Rehm, DPM
I read the well written responses to my article “The Birth of Podiatric Sports Medicine” in the comment section of PM News by the highly esteemed podiatric physicians Drs. Richard Bouche, Gary Dorfman, Mark Landry, and Lloyd Smith. My regret is that I appeared to highlight one pioneer over another and that was not my intent.
As I said in the second paragraph of my article: “The impetus for most of the interest in sports medicine by podiatrists back then arose out of the running boom and the development of the American Association of Podiatric Sports Medicine. Doctors George Sheehan, Robert Barnes, John Pagliano, Richard Gilbert, and...
Editor's note: Dr. Rehm's extended-length letter can be read here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Handy for dusting low objects? |
Source: Joyce Verhagen via Virtual Shoe Museum
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MEETING NOTICES
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NEED CME CREDITS FAST?
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Earn 15 CECH only $249 (less than $17 per CECH)
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Choose any or ALL from 25+ CECH Category-1 articles posted
*NY Licensees whose registrations are from 3/20-9/1/20 can take unlimited online credits
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| CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION – CLEVELAND SW SUBURBS
Excellent opportunity to join a 30 year old well-established busy two office location practice seeking a PSR-36 Board Qualified/Certified with ABPS. All phases of podiatry from surgery to wound care. Staff privileges at 3 local hospitals. Modern offices recently remodeled and equipped with certified EMR, digital x-rays and all aspects of DME. Significant opportunity for growth and development. Please forward CV to medical123@aol.com
ASSOCIATION POSITION IMMEDIATELY - CENTRAL PA
Looking for a location that provides a turn-key busy schedule from Day 1. Immediate opening in Central PA a multi-physician, multi-location practice wants you to focus on quality patient care. Equipment and supplies are provided. Revenue sharing compensation model. Positive attitude and compassion for all. Send your cv to jgutshall@pafootcare.com
ASSOCIATE POSITION - COUNCIL BLUFFS, IA
Immediate availability. Looking for ABFAS board certified or qualified podiatrist to join established, well-rounded practice. The ideal person should enjoy all aspects of practice including routine care, general podiatry, wound care and surgery. Salary, bonus and benefits. Send CV to drbarnes@cbfootcare.com
ASSOCIATE POSITION - KNOXVILLE, TENNESSEE AREA
Very busy and growing practice with multiple locations and doctors in booming Knoxville, Tennessee area seeks high energy and personable physician. Modern, office-based practice with readily available privileges at all local hospitals and surgery centers. Immediate volume to fill your schedule with a variety of patients ranging from complex surgical cases to routine foot care. Extremely competitive salary plus very generous bonus structure and benefits. Please send cover letter and CV to ddavidphawk@yahoo.com.
FULL TIME PODIATRIST- NORTHERN NEW JERSEY
We are a fast-growing podiatry practice in North Jersey with multiple locations and Doctors. We are currently looking for a full-time motivated and caring Doctor to join our busy practice. Some benefits include: competitive six-figure salary, generous bonus structure, health insurance (including vision & dental), paid vacation time off, paid malpractice insurance and CME time off. Great prospects for experienced Doctors as well as new Associates. This is an excellent opportunity to expand your Podiatric medical and surgical experience in an office-based practice! If interested, please submit your CV to DrSamofal@PodiatryCenterNJ.com
FULL-TIME or PART-TIME PODIATRIST - DALLAS/FORT WORTH AREA
PSR 24-36 Trained Multi-dimensional, Multi-office group treating a wide range of patients to include: forefoot, rearfoot, diabetic wound care, sports medicine and work-related injuries. Modern offices and equipment. A great opportunity for driven personable individual. Please e-mail Cover letter, CV, Letter of references Email: cnunez1940@gmail.com
HOME FOOT CARE, INC.- MOBILE PODIATRISTS-GREATER LOS ANGELES AREA
PRACTICE AFFECTED BY COVID-19? Need extra income? Mobile podiatrists needed immediately! Full or part time available to see homebound patients in the following areas: San Bernardino/Riverside, Lancaster/Palmdale, Ventura/Oxnard, Los Angeles/San Fernando Valley. Choose your own days/hours, excellent monthly compensation, cloud based EHR, dedicated support staff. (we do not service nursing homes, or large assisted living facilities) . If interested, email CV to: homefootcare@hotmail.com Check us out @ www.footdocs2u.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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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE - NORTHERN MISSOURI
24 year old, reputable, profitable podiatric practice for sale. Great school and family oriented community. Only podiatry practice in a large area. County seat with modern hospital. Turn-key and a bargain guaranteed. Must sell and move out-of-state to aid aging parents. Serious inquiries only please. 660-651-0264 keithb@cvalley.net
PRACTICE FOR SALE – NASSAU COUNTY NY
Well established part time 16 year old solo practice located in a great suburban neighborhood 1 mile from Mt Sinai South Nassau Hospital. Low overhead non-surgical turn-key practice with potential for expansion. Email: mfrisciadpm@aol.com
PRACTICE FOR SALE - SANTA BARBARA, CA
Well known 50 year old general, orthopedic and limited surgical podiatric practice. Revenues would increase with surgical expansion. Most desirable for one interested in the quality of life offered in Santa Barbara. $149,000. Contact santabarbarafootclinic@yahoo.com or call (805) 689-2084
PRACTICE FOR SALE – CHICAGO SUBURBS
Highly respected successful, solo podiatry practice for sale in upper middle class northern suburbs of Chicago. Affiliated with 2 major hospital physician programs with a surgical center available in office complex. Must be board eligible or board-certified. If you are a people person without a doctor’s complex, this turnkey practice is for you. With added social media, practice revenues could go up 10-20%. $ 900,000 Gross last several years working 4 half days a week. Traknet EMR, digital x-ray, computerized orthotics, with in-house PT. No Medicaid and no nursing homes. Will sacrifice for $500,000. Only serious inquiries contact k.peeler@comcast.net
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
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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.
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ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
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employee or agent responsible for delivering the message to the
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immediately notify me and you are hereby instructed to delete all
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