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| PM News | |
The Voice of Podiatrists
Serving Over 15,758 Podiatrists Daily
June 28, 2014 #5,097  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2014- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
LAST DAY TO VOTE
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| PODIATRISTS IN THE COMMUNITY | |
MA Podiatric Group Leads 4th Annual Sock Drive
It’s a simple concept and it’s common sense. Clean socks provide good foot health. Yet, most of us take it for granted. For some, dry and clean socks are a luxury. Which is why, every year for the last four years, Beth Israel Deaconess Medical Center (BIDMC) has been collecting new, white socks for the homeless men, women, and children of Boston. It’s part of Sox for Socks, a program coordinated by Boston Health Care for the Homeless Program (BHCHP) in partnership with the Red Sox Foundation.
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Dr. John Giurini |
"When I learned about this program, I knew it was something we had to do. As a foot specialist, I’m acutely aware of the dangers of wearing damp shoes and socks or going barefoot. All the foot physicians on our team are dedicated to this cause, too," says Dr. John Giurini. Between now and August 1, BIDMC is hosting its fourth annual Sox for Socks Drive. The hospital sock drive is led by the Division of Podiatric Surgery and the Committee of Social Responsibility of the Department of Surgery at BIDMC.
Source: Wellesley Patch [6/26/14]
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| INTERNATIONAL PODIATRISTS IN THE NEWS | |
"Cinderella Surgery" Popularity Due to Sex and the City Style Shoes: UK Podiatrist
The newest trend in cosmetic surgery is the "Cinderella Surgery." Women are having their feet altered to better fit into designer shoes. The surgeries can involve changing the length of toes or removing ugly bunions and painful corns. There's even something called "toe lipo," which is used to make a chubby toe slim. Podiatric surgeon Dr. Jason Hargrave says the cosmetic surgery is fueled by the popularity of the Sex-And-The-City-style killer heels.
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Dr. Jason Hargrave |
However, not all doctors agree with the surgery. The surgeries are highly invasive, involving cutting open the toes, sawing the bones and then screwing them back together. There is a high risk of complications, like permanent foot pain and restricted joint movement.
Source: Rebecca Lewis, Fox 47 News [6/25/14]
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| PODIATRISTS IN THE COMMUNITY | |
IL Podiatrist Participates in BizEd Expo
A crowd of more than 700 flocked to Barrington High School on Saturday for the first-ever BizEd Expo, which featured area businesses alongside innovative District 220 programs. Businesses of all kinds, from retail to automotive to healthcare, were featured. Dr. Anna Gurrera, a podiatrist with Alpine Foot Specialists in Lake Zurich, said the event was “good for business. We had plenty of people come by our booth.” Gurrera, whose practice joined the Barrington chamber a year ago said, “It was nice to meet other vendors in the area.”
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Dr. Anna Gurrera |
Alpine specializes in foot and ankle surgery and treatment for conditions including arthritis, and ankle and nerve conditions, Gurrera said. She and her colleagues were able to answer questions attendees had about foot and ankle conditions and connect with other businesses. “We also brought some products with us, like custom shoes and diabetic shoes,” Guerrera said. Alpine treats patients clinically at their Lake Zurich facility and surgically at Advocate Good Shepherd Hospital in Barrington. “That’s how we’re tied to Barrington — we do surgery at Good Shepherd Hospital.”
Source: Bridget O'Shea, Barrington Sun Times [6/18/14]
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| E- HEALTH NEWS | |
Verizon Introduces Virtual Visits, New Telehealth Offering
Verizon is taking another step into healthcare with the introduction Wednesday of its Virtual Visits program. The goal is to facilitate connections via phone, tablet, or laptop between healthcare providers who contract with Verizon and their patients for what Verizon terms routine, urgent care.
An interested patient would boot up the system, have eligibility verified and co-payment collected, and then be led through a series of questions. Depending on the answers, the patient would be triaged into the appropriate groups by a provider for a virtual video visit. From there if, for example, a prescription is needed, a doctor would send it to the appropriate pharmacy.
Source: Darius Tahir, Modern Healthcare [6/25/14]
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| QUERIES (MEDICAL/LEGAL) | |
Query: Legality of Pharmacy-Based Study
Out here in Las Vegas, there is a pharmacy offering our preventive foot care network a relationship in which the company would place paid newspaper ads for a study of the use of their topical products, particularly for peripheral neuropathies. Half the patients get the product, half get a placebo for two weeks. If there is no improvement, and they have been given a placebo, they then get the actual medication.
The ads announce the study, and tell patients they can call the podiatrist for an appointment. The medication is provided to the patients free for the two-week study duration, but after that, if they are improved, and have been using the actual product rather than a placebo cream, they receive it at a discounted price or their insurance is billed. This brings new patients to an office, but the question is whether it is problematic. I suppose a healthcare attorney is the one to ask, but maybe there are comments.
Lawrence M. Rubin, DPM, Las Vegas, NV
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| CODINGLINE CORNER | |
Query: Psoriatic Heel Icthyosis and Hyperkeratosis
I have a traditional fee for service (FFS) Medicare patient who has severe psoriatic dermatitis. Having exhausted topical compounds and all the topical steroids, we even tried special socks - with minimal success. This patient also has painful psoriatic plantar calcaneal spurs, so we've made accommodative orthotics to off-load the heel area as well; again, with minimal success.
His dermatologist has been injecting steroids into his fingers and wrists for years to resolve the dermatological eruptions there. These actually cause the lesions to completely resolve for at least 3-6 months. Certainly, I could attempt to do the same therapy on the skin around his heels. From the coding perspective, what CPT code would be appropriate? Would I code each injection site or simply bill for one injection on the left foot and one for the right? I am assuming I'd also bill for the therapeutic steroid given.
Paul Kesselman, DPM, Woodside, NY
Response: Take a look at codes CPT 11900 (injection, intralesional, up to and including 7 lesions) and CPT 11901 (injection, intralesional, more than 7 lesions).
Do these codes describe what you anticipate doing for this patient? If so, then it wouldn't make any difference whether one or both feet are treated. You'd just count up the number of lesions injected and select which of the two codes above is represented by that count.
Joan Gilhooly, CPC, CPCO,Lebanon, OH
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription
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ACE USA and RPS Healthcare Expand Podiatrist Professional Liability Coverage
The Patient Protection and Affordable Care Act and Centers for Medicare & Medicaid guidelines and rules resulted in a record number of investigations and enforcement actions in 2011. ACE Medical Risk, a division of ACE USA, has responded through an endorsement that increases limits on Medicare/Medicaid legal expense reimbursements, raising coverage limits from $30,000 to $50,000 per action, with an annual aggregate of $50,000. This product is underwritten by companies within the ACE Group, an A.M. Best “A+” rated carrier, and is offered to podiatrists exclusively by RPS Healthcare, National Program Administrator of the Podiatry PLUS programs and one of the largest wholesalers and the largest Managing General Agent in the country. For more information Call 800-397-9697 ext 2646.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Thomas Graziano, DPM, MD, Evan F. Meltzer, DPM
Your presentation of an "excessively large accessory navicular" is not atypical. You can remove the entire accessory bone and perform ostectomy of the navicular. If there is need to reattach the posterior tibial tendon, use one of the many anchoring systems available to perform the tenodesis. If you are unfamiliar with the technique, refer the case out to someone who performs the procedure and scrub in with him/her. I found it amusing in your post when you stated, "the patient or parent wants the entire bone removed." It's not up to the patient or parent what treatment is necessary. It's up to you - the doctor.
Consider contacting your local Arthrex representative and have them show you their various bio-absorbable soft tissue anchors. The appropriate anchor will hold the posterior tibial tendon at its insertion until it is healed, and then it will gradually absorb. The absorbable feature is ideal for your young patient. Ask the rep to bring a saw bones model for you to practice on prior to your case.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Peter Bregman, DPM
In this case, it is likely that the patient has some sort of Kidner foot type. Since x-rays were not provided, I'm going to assume that. I would probably recommend placement of a subtalar implant. In this case, I prefer HyProCure. As far as the gap is concerned, simply do tendon advancement and use a bone anchor/tenodesesis device, and everything should be fine.
If necessary, you can also use some sort of augmentation. Arthrex has just come out with a new one that you can use for spring ligament reinforcement, which might be beneficial, but the advancement of the posterior tibial tendon is probably enough. If the foot is not flat at all, you can just use a tenodesesis device more proximally. The bottom line is just be prepared for any of these scenarios and do what needs to be done. Don't do something less just because it's a child. In fact, do the opposite; be more aggressive, so another surgery will not be needed in the future.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1C | |
From: Eric Edelman, DPM
If it were my case and I "ran out" of posterior tibial tendon after removing the accessory navicular bone, I'd do one of these:
1. Place Krackow non-absorbable sutures into the proximal stump of the PT tendon and approximate to suture from a bone anchor you have inserted into the navicular. Close and cast in slight inversion.
2. FDL transfer.
In a 13 year old, I'd plan on a fiberglass cast for 4 weeks, a CAM-walker boot for 4 weeks, and then a lace-up sneaker or hiking boot with an orthotic with a medial flange for one year.
Depending on what the rest of the foot and gait look like, a bone procedure could be appropriate, but your case sounds like a big piece of bone that's causing irritation, not painful flat feet.
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MEETING NOTICES - PART 1
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Does this car need orthotics to stay in proper alignment? |
Source: Fortune via Dr. Elliot Udell
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MEETING NOTICES - PART 2
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| CLASSIFIED ADS |
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EQUIPMENT FOR SALE - OPAL-RAD DIGITAL X-RAY (DR)
20/20 Opal-Rad digital x-ray unit 4 years old only used sparingly and is “like new.” X-rays obtained by x-ray company showed that the unit is performing optimally when dismantled for storage and shipping. $10,000 OBO. DrRhodes2@aol.com
PRACTICE FOR SALE - BOSTON, NORTH SHORE
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PRACTICE FOR SALE – DELRAY BEACH, FL
Rare opportunity for turn-key practice in Delray Beach, Florida. EMR compliant. All office-based revenue. Full time busy practice. Owner willing to assist with transition as long as needed. Priced to sell. Serious inquires only please. Email for more information: podpractice55@gmail.com
OFFICE FOR SALE - S.E. FLORIDA
20 year old office, South Palm Beach County. Owners looking to semi-retire. Location in very busy section of Delray - Boynton. Serious inquiries only. Asking $175,000. Email reply - Bafamt@aol.com
SPACE TO SHARE - MANHATTAN AND LI
Desirable locations on Upper East Side, Gramercy, the Financial District, and Plainview (North Shore Long Island). Extremity MRI and cat scan available in selected offices. Call 516 476-1815 PODO2345@AOL.COM
PART-TIME POSITION - CENTRAL NEW JERSEY
Looking for a motivated, caring, ethical associate. Approximately 10 hrs/week. (Tuesday AM - Thursday PM) Room for expansion in this well-diversified practice. Salary + commission based. Send CV to:NJPodiatry1@gmail.com
ASSOCIATE POSITION – CONNECTICUT
Immediate position for full time ethical and motivated surgeon for a busy single location practice. Competitive compensation available leading to buy in. Board certification a plus but must have excellent forefoot and rearfoot experience. Just miles from a residency training program with hospital privileges available. bfsoffice@4udr.com
ASSOCIATE POSITION- HUDSON VALLEY REGION, NY
Hudson Valley Foot Associates has a great opportunity available! We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM. Please visitwww.hvfa.com and forward cover letter with CV to info@hvfa.com
WELL ESTABLISHED AND EXTREMELY BUSY PRACTICE - SOUTHERN CALIFORNIA
Seeking surgically trained, Board Certified/Board Eligible podiatrist immediately. Competitive salary and benefits compensation offered for all aspects of care including surgery, office hours, nursing home and managed care. Spanish speaking is a definite plus. We have EMR and digital x-ray. Please email your CV and coverletter to ocpodiatryoffice@gmail.com
ASSOCIATE POSITION – NYC
Busy surgical podiatry group looking for a part time associate to start immediately. This position can lead to full time work within 6 months. Must be willing to rotate through offices in Brooklyn, Queens, and Manhattan. Great opportunity for personal and professional Please contactdrlevy@starrettpodiatry.com.
ASSOCIATE POSITION – BROOKLYN, NY
Excellent opportunity for a motivated, ethical, and enthusiastic associate to join a successful, well established hospital affiliated practice. Must be residency trained PSR 24/36. Board eligible/certified by ABPS preferred. Must be component in forefoot and rear foot surgery. Competitive salary with incentives commensurate with performance. Email CV to manfootcare@aol.com or fax to: 718-875-3171
ASSOCIATE POSITION - CENTRAL NEW JERSEY
Immediate FT opportunity for an associate position leading to buy-in/partnership. Self motivated, hardworking individual surgically trained to join 30 plus year very well established practice with high patient volume. Competitive salary and benefit package. Send CV to jerseypod@gmail.com
ASC STAFF PRIVILEGES AVAILABLE - NEW JERSEY
Fair Lawn ASC (ambulatory surgical center) is accepting applications for staff privileges. NJ license needed. Patient transportation available in the tri state area. Equity buy-in available. Call 516 476-1815 PODO2345@AOL.COM
PM News Classified Ads Reach over 15,500 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 15,500 DPMs. for details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451
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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
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
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