The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

June 29, 2013 #4,809 Publisher-Barry Block, DPM, JD

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FL Podiatrist Appointed as Professor in School of Medicine

Dr. R. Daryl Phillips

R. Daryl Phillips, DPM, Chief of Podiatry, Orlando VAMC has been appointed as Professor of Podiatric Medicine at the University of Central Florida, School of Medicine. His role at the medical school includes stimulating the learning of students via independent study, leading small group sessions, demonstrating skills, and presenting lectures.

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Providers Skeptical of Expanded Physician Compare Site

The CMS is touting its redesigned Physician Compare website as being a more useful and usable tool for the public to check out physicians and other healthcare providers. But provider organizations remain skeptical, saying they'll believe it when they see it. Mandated by the Patient Protection and Affordable Care Act, the Physician Compare website went live in 2010. The redesigned website now includes information on whether a physician is participating in HHS' electronic health record financial incentive program, board certification and affiliations with hospitals and other professionals.

Previously, it included such information as providers' location, specialty, education, languages spoken, and gender, which critics noted was already available elsewhere on the Internet. Types of providers in the database include physicians, chiropractors, dentists, podiatrists, anesthesia assistants, certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists, dieticians, nurse practitioners, physician assistants, psychologists, social workers, and physical, occupational, and speech therapists.

Source: Andis Robeznieks, Modern Physician [6/28/13]

Query: PECOS Revalidation Fee

This issue came up several months ago. We sent in the revalidation forms. Today, we got a call from PECOS saying we owe the $532 and that they didn't process our application. We were initially told that the fee didn't apply to our office. Has anyone else run into this problem?  Their employees sometimes are great and get it right, but when they get it wrong, it causes all types of trouble for your practice. 
 
George Jacobson, DPM, Hollywood, FL

Query: Repeat Partial Procedure Within Global Period 

I performed a tenotomy (dorsal and plantar) and capsulotomy (CPT 28011) and realized that the plantar tenotomy wasn't complete. I re-did only the plantar tenotomy (CPT 28010) within two months of the original procedure. Is the second procedure billable?

If so, would I code the procedure with a "-58" staged related procedure during post-op period modifier, or a "-76" repeat procedure during post-op period modifier (even though it was only partially repeated), or a "-78" return to OR for related procedure during post-op period modifier?

Ron Werter, DPM, New York, NY

Response: Repeating (revising the incomplete plantar tenotomy) plantar tenotomy within two months of the original procedure would be an "unplanned related return to the operating room in a global period" and should be appended with a "-78" modifier.

It is not a staged - pre-planned - procedure ("-58" modifier).
It is not a more extensive procedure than the original procedure ("-58" modifier).
It is not a repeat procedure ("-76") even though you indicate that you re-did the plantar tenotomy.

Why not use repeat procedure modifier "-76"? Because AMA guidelines in "Coding with Modifiers" (Deborah Grider), the American Medical Association's book on correct CPT and HCPCS modifier usage notes that "modifier 76 is used to indicate that a procedure or service was repeated in a separate operative session ON THE SAME DAY by the same surgeon." You stated the repeat procedure was performed "within 2 months of the original procedure." CMS guidelines also note that the repeat procedure or service is performed on the same day.

Harry Goldsmith, DPM, Cerritos, CA

Codingline subscription information can be found here

APMA Members: Click here for your free Codingline Silver subscription

RE: MIS For Bunionectomies? (Randall Brower, DPM)
From:  Michael Lawrence, DPM

I read the post of Dr. Brower and his thoughts now would accurately reflect my thoughts not that long ago. And looking at his intra-op photos, I could name names of patients whose joints looked just like that; and I performed the same procedures as Dr. Brower did on them. I have every reason to believe that Dr. Brower is a fine foot surgeon and a credit to our profession. With that said, I would like to make a few points.

Are we absolutely sure that the chondral defect has to be repaired in a situation as presented? I'm sure we all come across some...

Editor's comment: Dr. Lawrence's extended-length letter can be read here.

RE: The Bell Tolls For Us (John F. Swaim, DPM)
From: Paul R. Scherer, DPM

I started to read Dr. Swaim’s comments and was not interested until he mentioned Podiatry Plan and ProLab. If he has JUST come to the realization that solo private practice will soon migrate to hospital-based groups and multi-specialty groups, then he has proven that Darwin was right.

Podiatry Plan, to correct an error in his post, pays a total of $338 for orthotics, not including two follow-up orthotic visits for $65 per visit – a total of $468. A good fully corrected and posted functional orthotic device from a legitimate laboratory costs about $100, the same price as in 1996. If an insurance company doesn’t pay for orthotics, I suggest to the doctor that he consider a unique alternative – bill the patient.

Paul R. Scherer, DPM, San Francisco, CA, hpoc@aol.com

RE: TRAKnet Charges (Marge Portela, DPM)
From: Michael DiGiacomo, DPM, Kevin K. Lam, DPM

I am a TRAKnet user and have been very pleased with the system compared to Epic, which my medical center uses to many physicians' dismay. I happily pay the fees needed to continue this service and prefer not having to issue checks. That this company is now in the control of our colleagues is comforting.

Michael DiGiacomo, DPM, Oakland, CA, mddpm2003@yahoo.com

The problem I see is that we have been jumping from podiatry program to podiatry program, Medinotes, now TRAKnet, etc. While it is great for ease-of-use, the problem with companies going out of business due to a narrow market is inevitable. If you only target one market, your base will be low. We are currently looking at Practice Fusion (Free), Kareo (free EMR), Athena (free). The last two make money on the PM side.

While podiatric-specific EMR was great back before the days of meaningful use and...

Editor's note: Dr. Lam's extended-length letter can be read here.

RE: Unmatched Residency Placements Currently Stand at 92 (Eric Roberts, DPM)
From: Leonard A. Levy, DPM, MPH

While Dr. Eric J. Roberts is correct that there are a substantial number of MD and DO graduates who do not match in the ACGME and AOA residency matching program, these unmatched graduates still are able to obtain a program, albeit one that may not be the one they preferred. This statement is based on information I've received every year in my position for the past 14 years as Associate Dean of Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Florida. In fact, many foreign medical graduates fill residency slots that still remain open.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL, levyleon@nova.edu

RE: Unmatched Residency Placements Currently Stand at 92
From: Michael M. Rosenblatt, DPM

I read Dr. Robert's letter defending "podiatric Darwinism" with the greatest regret and sadness. He fell into the chuckhole that many in APMA/CPME fell into, without even realizing it, when he compared MD programs to DPM programs. There will never be such a valid comparison, because even if MDs don't get their favorite residencies, they will in fact be able to secure a license to practice family medicine. True, they may never get board-certified or the ability to do minor procedures, but they will have small communities all over the U.S. scrambling to hire them.
 
I admit that many will be "forced" to live in a small town, but they will have no trouble paying off their college loans. The DPM degree has only one business model: patient care entrepreneurial private practice. It is not transferrable. There are no small towns competing to get us to move there.
 
Worse, in the majority of states, those without a program will NEVER get licensed and never pay back their college loans. Dr. Robert's attitude, in its stripped down Darwinism is regrettable and shocking. The DPM degree (without patient care) is the most expensive paperweight you can buy.
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: Unmatched Residency Placements Currently Stand at 92
From: Stuart J Wertheimer, DPM

One of the benefits of being "in retirement" from the Council on Podiatric Medical Education is being able to sit back and take a hard look at the Council. As a former member of the CPME, past chair of the Council and the residency review committee, and having participated in 98 site visits since 1994, I believe I am in a position to comment on some of the inaccuracies that have been stated on the relationship between the Council and the profession.

From 1990 to 2006, many changes took place in the Council – the development of PM&S programs, implementation of an approval process for fellowships, the move to...

Editor's note: Dr. Wertheimer's extended-length letter can be read here.

RE: Outrageous Tattoo of the Day

Does this still qualify as barefoot running?

Source: Submitted by Dr. Carrie Nelson

ASSOCIATE POSITION - TAMPA BAY

Live, play and practice in the Tampa Bay area. Associate leading to partnership in a well-established, expanding group practice. Excellent salary and benefits in this dynamic medical/surgical practice. Come join our caring, compassionate, motivated staff. Position open immediately but we will also consider 2014 residency graduates. PSR-36 or PSR-24 with rearfoot/ankle training required. E-mail cover letter, CV, surgical log and references to rvalins18@aol.com

ASSOCIATE POSITION - CONNECTICUT
 
Looking for an associate with 3-year residency training for a practice in Connecticut. Interested in all aspects of podiatry including  foot/ankle surgery and wound care. Hospital located close by with appointment to staff readily available. Will lead to partnership Please send CV to: dsharnoff@hotmail.com

ASSOCIATE POSITION - SOUTHERN NEW JERSEY

Excellent opportunity for a full time podiatrist to join busy group practice! Surgery, wound care, sports medicine. Affiliated with residency program. Personable and great communication skills a must! Competitive salary, bonus, benefits package. Send CV to footdoc22@gmail.com

ASSOCIATE POSITION - KENTUCKY

Immediate opening in beautiful Southern Kentucky with 8-provider group with excellent reputation, full-time physical therapy, MRI, CPED/CO on staff along with a full schedule awaiting.  Wonderful place to raise a family, excellent schools and phenomenal quality and cost of living. Excellent compensation package, full benefits, and buy-in opportunity after 2 years. Email a letter of interest and CV: jonkim12000@yahoo.com

ASSOCIATE POSITION - CHICAGO

Associate Needed to do housecalls; part - or full-time ; make you own schedule ; logistical support provided; will net at least $1,000/week working approx. 15 hrs, Contact dpms2@hotmail.com 

ASSOCIATE POSITION - SOUTHERN CALIFORNIA
 
Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

ASSOCIATE POSITION IN SOUTHERN CALIFORNIA

Full-time, motivated, outgoing associate wanted for immediate job opening. We are a multi-office, multi-doctor practice based in Orange County and we’re looking for a hard working individual to treat wide range of patients. PSR 24 training a must and Spanish speaking a definite advantage. Email your CV to: ocpodiatryoffice@gmail.com.

ASSOCIATE POSITION - BAKERSFIELD, CA
 
Office and hospital-based podiatry group seeking a highly trained surgical associate to complement our 3-doctor group. Minimum PSR-36 trained with rear-foot reconstructive experience required. Must have CA license and x-ray and fluoroscopy license. Previous practice experience is preferred. Competitive salary and benefits package. Please forward cover letter and CV to modpm@aol.com

ASSOCIATE POSITION - TEXASDynamic, busy practice in Dallas/Fort Worth area, seeking surgically trained, Board Certified/Board Qualified Podiatrist, PSR-36 preferred. Excellent salary and benefits compensation package, for the right candidate, who is motivated to work hard. Contact/Send resume to: jmh6122@yahoo.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITIONS – MARYLAND (FULL-TIME/PART-TIME)

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to: drhprosen@verizon.net or fax 410-486-2049 or call Dr. Herbert Rosen 410-580-0255.

ASSOCIATE WANTED - MANHATTAN AND NORTHERN NJ

For group practice. Excellent opportunity to be the first podiatrist to join our team! PT/full-time negotiable. Convenient on-site surgical center. Current licensure in NJ and/or NY required. Call Gina 212-223-0716 or email CV to gina@premiersurgicalpavilion.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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed PODO2345@AOL.COM 516-476-1815.

PRACTICE FOR SALE – VIRGINIA

Well-established practice in North Arlington (Clarendon) being sold at" below market" price in exchange for prompt closing in the next 45 days. Fabulous neighborhood. 3 well equipped rooms- Midmark model# 417 ADA compliant treatment chairs w matching doctors stools, brand new X-cel x-ray machine ADA compliant w orthoposer 3 inches above ground & hand grips. m-11 autoclave. priced below market in exchange for closing in 45 days. Retiring doctor will assist in introducing you to PCPs & specialists for 3 to 6 months. Virginia license and one year approved residency required. Contact by e-mail @ drmichaelfine@aol.com,  (c) 703-582-5999, (h) 703-237-0841

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER
 
This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at footcare@comcast.net. for questions and pricing.

PM News Classified Ads Reach over 14,000 DPMs and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 14,000 DPMs. Write to: bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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