The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

June 30, 2012 #4,502 Publisher-Barry Block, DPM, JD

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PM Introduces 1st Winner of Facebook Contest

Podiatry Management is proud to announce the launching of its new Facebook page www.facebook.com/PodiatryManagement We encourage you to visit it. 

Dr. Patricia Casey Kirk

The winner of this week's contest is Dr. Patricia Casey Kirk of Lexington, TN. There has been an overwhelming response to our new Facebook page, so we are giving away another  prize this week. Simply like us and be eligible to win a free registration for the Greenbrier Coding and Practice Management Workshop (Value $395). Enter now. The contest ends July 7th, 2012. No Purchase necessary.

CA Podiatrist Comments on Supreme Court Decision on Affordable Care Act

Dr. Lee Rogers, candidate for U.S. Congress, released the following statement on the Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act: “Today’s Supreme Court decision is bittersweet. The Supreme Court upheld the Patient Protection and Affordable Care Act in its entirety, including the controversial individual mandate to purchase health insurance.

Dr. Lee C. Rogers

“The good news is that people who have already benefited from the law will continue to benefit. But the bad news is that the law still needs to be fixed. No law is perfect, but this one benefits the big health insurance companies like no other. The law prevents insurers from denying coverage for pre-existing conditions, but it doesn’t put a cap on premiums. Although you can’t be denied coverage, you can still be priced out of the market, essentially accomplishing the same thing. Going forward, we need to have at least one option for patients that insurance companies don’t control."

Source: The Santa Clarita Valley Signal [6/28/12]

OH Podiatrist Comments on Supreme Court Decision on Affordable Care Act

Doctor and candidate for Congress, Brad Wenstrup, released the following statement on the Supreme Court ruling on Obamacare. "The Supreme Court's decision is a disappointment, and an insult to the large majority of Ohioans who opposed Obamacare by their vote for Issue 3 last year. Despite the disappointment, the decision shouldn't be a period at the end of the healthcare debate, but rather a comma that allows us to pivot towards further common sense reform. We must continue our efforts to repeal and replace this massive government expansion and tax increase.

Dr. Brad Wenstrup

That's why I'll push for patient-centered solutions like tort reform, health insurance portability, the promotion of health savings accounts, and allowing individuals and groups to combine and purchase insurance together. And I'll fight to protect the doctor-patient relationship, because doctors - not bureaucrats - know what's best for their patients."

New SNaP® Bridge Dressing For Plantar Wound Care

Spiracur Inc., the developer of disposable, non-powered negative pressure wound therapy (NPWT) solutions, has announced the introduction of the SNaP® Wound Care System's Bridge Dressing for the plantar surface of the foot. The new dressing is designed to move pressure points off of the wound and deliver effective, continuous treatment. When partnered with an off-loading device, such as a protective boot, it offers a complete solution to treat plantar surface diabetic foot ulcers (DFUs), one of the most incapacitating complications resulting from diabetes.

Dr. Leslie Oldenbrook

"Amputations as a result of non-healing or untreated DFUs are devastating for patients and extremely costly to our healthcare system, accounting for an estimated $116 billion in direct medical costs," said Leslie Oldenbrook, DPM, from the O'Connor Wound Care Center. "It is imperative that DFUs are treated immediately because the longer a wound remains unhealed, the greater the risk to the patient. The SNaP Bridge Dressing offers an advanced negative pressure therapy solution for treating plantar surface DFUs by removing any additional hard pressure points from the weight-bearing surface and providing continuous, safe therapy," continued Dr. Oldenbrook.

Source: Device Space [6/28/12]

Man Who Traded Cocaine for RXs With ME Podiatrist Sentenced

A Connecticut man who traded cocaine for prescriptions for oxycodone with a podiatrist was sentenced Friday in U.S. District Court to a year and three months in federal prison. Dariem Vanalstyne, 25, of New London, CT, pleaded guilty in February to four counts of acquiring drugs by deception.

Vanalstyne traded cocaine for prescriptions for oxycodone from Dr. John B. Perry on at least four occasions in 2009, according to the prosecution version of events to which Vanalstyne pleaded guilty. Perry, 51, of Bridgton was associated with Atlantic Foot & Ankle Center in Portland, when he allegedly traded prescriptions for narcotics for cocaine. If convicted, Perry faces up to 20 years in prison and a fine of up to $1 million.

Source: Judy Harrison, Bangor Daily News [6/29/12]

Query: Severe Metatarsalgia
 
This 77 y/o female underwent B/L forefoot surgery 40 years ago by an orthopedist. She has been "permanently disabled" ever since. She had two revisional surgeries shortly thereafter which also failed. She has severe B/L metatarsalgia sub 1st-5th MTPJs to the point where she can barely walk now, despite multiple different accommodative inserts/pads.

Chronic Metatarsalgia

She has received several other opinions over the years and has been told "nothing can be done." I am considering resecting met heads 2 and 5 with a 1st MPJ fusion. Curiously, she also has severe pain on palpatation of the 3rd and 4th met stumps. Any other thoughts on how to address this?
 
Judd Davis, DPM, Colorado Springs, CO

Query: 17110 Denial

I was recently denied payment for a second 17110 (destruction of benign skin lesion [wart], any method), at 2 weeks following the first treatment of 17110 on two patients by both UHC and AARP/ Medicare Complete, which is also UHC. The reason for denial was "within global period".

We called UHC and were told that the global period for CPT 17110 is 90 days. They said that 90 days is the Medicare global period, and we should use a -59 modifier and the additional 'pain in foot' diagnosis for the AARP plan. I assume that the regular UHC plan will tell us the same thing. Are they confusing or lumping 11401, excision of lesion, with the local distruction code?

Ron Werter DPM, NY, NY 

Response: CPT 17110 has a 10-day, not a 90-day global period. Call back and speak with a supervisor.

Lori Braschler, CCS, Bakersfield, CA

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RE: Chronic Post-Op Pain (Joe Borden, DPM)
From: Howard Dananberg, DPM

I have found that patients with pain sub 4/5 often have a restriction in dorsal range of motion of the lateral column of the foot. Examination is performed by holding the rearfoot stable with one hand, and then using your thumb on the plantar surface of the 4th/5th met heads and applying a dorsiflexion force. The lateral column should be upwards. Compare it to the non-painful side. If this test is positive, manipulate the cuboid. This can immediately relieve this type of symptom. More info on cuboid manipulation can be found at vasylimedical.com. 

Disclosure: I am a consultant to Vasyli Medical. 
 
Howard Dananberg, DPM, Bedford, NH, hdananberg@gmail.com

RE: Cancelled ADA Visit (Alex Dellinger, DPM)
From: Barry Block, DPM, JD

Unfortunately, under the curent ADA rules, you are still responsible for paying for an interpreter when a patient cancels an appointment or is a no-show. There are, however, ways to prevent this from recurring, including 1) Arrange with a hospital that you have privileges in to see the patient there. Most hospitals have interpreters for the deaf on staff at no additional cost to you. 2) You can charge any patient a no-show fee as long as it is posted so that all patients have adequate notice. 3) Discharge the patient for being non-compliant. You will need to adequately document this.    

Note: This is general information and should not be construed as legal advice.

Barry Block, DPM, JD, Forest Hills, NY, bblock@podiatrym.com

RE: E-Prescribing (Martin G. Miller, DPM)
From: James R. Christina, DPM

The G8553 can be reported for a Medicare patient any time an eRx is done, however, this applies only to accumulating the required 10 eRxs by June 30, 2012 to avoid the eRx payment reduction in 2013. To qualify for the eRx incentive payment in 2012, use only qualified visits, i.e. those visits that are listed in the denominator of the eRx measure (Patient encounter during the reporting period (CPT or HCPCS): 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109). 

So, after Saturday June 30, 2012, the only reason to report eRx (G8553) would be if you are attempting to receive the eRx incentive payment for 2012 (1% bonus for all Medicare Part B charges for the year) and you would report in conjunction with one of the qualifying CPT or HCPCS codes listed above. To qualify for the incentive payment, you must report 25 (or more) unique qualified eRxs for the entire year.  Finally, remember if you qualify for the EHR Meaningful Use incentive payment, you will not receive the eRx incentive payment.
 
James R. Christina, DPM, Bethesda, MD, JRChristina@apma.org

RE: NY Assembly Passes Expansion of Scope of Practice Law
From: Michelle L. Butterworth, DPM

Congratulations to NYSPMA and their allies for their hard work on an expanded scope of practice act. Having been part of a similar effort in my state, I know how much time and effort goes into these campaigns. This bill should be considered a victory, not only for New York foot and ankle surgeons, but for the five remaining states where the ankle isn’t in the scope statute – and states where efforts to repeal the ankle or rearfoot scope could resurface.
 
ACFAS has advocated for New York’s approach in other states, where it has usually been viewed by our opponents as a reasonable compromise.  In fact, in one state, the orthopaedic association president (who was involved in the AMA’s Scope of Practice Partnership initiative), said such a compromise could solve his and other state scope disputes. Unfortunately, his overture was not accepted by the podiatric community, and that scope dispute lingers on.
 
Bravo to New York’s podiatric community – and most importantly to New York residents, who will soon have greater access to more of the best trained and board certified foot and ankle surgeons in the nation.
 
Michelle L. Butterworth, DPM, President, American College of Foot and Ankle Surgeons, mbutter@ftc-i.net

RE:  NY Assembly Passes Expansion of Scope of Practice Law (Bryan C. Markinson, DPM)
From:  Mark J. Tuccio, DPM

The devil is always in the details and this is, without a doubt, a perfect example of that statement. That said, what exactly does the scope of practice law in NYS have to say about podiatrists treating lower extremity leg ulcers? I am interested to hear from those in the state level who know the statute forwards and backwards.
 
Mark J. Tuccio, DPM, Jamestown, NY, mtuccio1@stny.rr.com

Codingline & PM News In conjunction with AAPPM Present
The Greenbrier Coding & Practice Management Workshop - August 20-22

(Following the 2012 APMA Annual Scientific Meeting in Washington, DC)

The Infinity Pool at the Greenbrier

Coming to Washington D.C. for the National? Don't miss out on being treated like a President and First Family. Enjoy world class amenities including golf, tennis, spa, casino and children's programs.

Speakers: Harry Goldsmith, John Guiliana, Barry Block, Michael Brody, Paul Kesselman, Jonathan Moore, Rem Jackson, Chad Schwarz, and other nationally-known authorities in morning-only presentations.

RESERVE YOUR UPGRADED ROOM BY JUNE 3Oth

Click Here for information or to Register

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@comcast.net

WANTED TO PURCHASE- PINPOINTE LASER

Seeking to purchase Pinpointe used laser. Willing to pay top dollar. Please contact us at: sbalandrano@zapnails.com or (1) 713-541-3764. Product Information: Product: PinPointe (Patholase) Company: Cynosure / PinPointe Type: Nd:YAG Options: Podiatry/Toenail

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 516 476-1815PODO2345@AOL.COM

PRACTICE FOR SALE – KANSA  SOUTHWEST

For sale multi-location practice in beautiful Southwest Kansas. Practice has 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Recently added new office space with digital x-ray. Only surgical podiatrist in 2 of 3 locations. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice, a great location and opportunity for the right doctor. mcrosby@picagroup.com

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

ASSOCIATE POSITION – VIRGINIA

Two office practice, hospital and surgery center privileges, trauma call, modern offices, EHR, digital x-rays. Excellent compensation package. Position may lead to partnership. Candidate needs to be experienced in foot and ankle reconstruction and trauma. Email letter of interest and CV to Dr. Joe Disabato at jdisabato@vfasa.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-Time Associate needed for busy multi-office locations in LA, Orange, San Bernardino and Riverside counties. SIX FIGURE SALARY PLUS BENEFITS!! Knowledge of Spanish is helpful. Good mix of office patients, house calls, some surgery, etc. NO NURSING HOMES!! Needed immediately. If interested, please send contact information and CV to scpodgroup@yahoo.com

ASSOCIATE POSITION - CENTRAL NEW JERSEY

Podiatry office in Central NJ- Looking for a three year surgically trained associate who has entrepreneurial spirit for a very busy office. You will see new patients and have the potential to become board certified in two years. Partnership guaranteed within three years for the right person. Must be very outgoing and personable. Great opportunity for a person who is confident and a go getter." Please fax your CV to: 732-968-8821.

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-time/Part-time, motivated, outgoing associate wanted for immediate job opening. Multi-office, multi-doctor practice based in Orange County, is looking for 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 – WILMINGTON, DELAWARE

Seeking full time associate, PSR 24/36 Board Qualified/Certified that is personable, highly motivated, ethical and hard working. Established 25 years old, well rounded, and busy practice. In large primary care based medical building with lab, X-ray, CT, ASC and medical aid unit. Multilingual is beneficial. Offering competitive salary with bonus opportunities and wide range of benefits. Partnership potential. Cover letter / CV to: Del.DPM@gmail.com

ASSOCIATE POSITION - DAYTON, OHIO

Seeking motivated PSR 24/36 trained Podiatrist for busy established practice; EMR established; Good surgical opportunity; Competitive salary and benefits. Send CV to:  podreply@gmail.com

ASSOCIATE POSITION - MASSACHUSSETTS

Looking for an extremely hard working podiatry associate for part-time work, opportunity for full time. Busy and expanding podiatry practice in the Merrimack Valley. Will work in both office and nursing home setting. In office, we have laser technology, electronic medical records, diagnostic ultrasound, x-rays, etc. Please email us at: resumesent11@comcast.net if you have interest in this position. If we find the right person, this opportunity could lead to partnership. Looking forward to hearing from you.

ASSOCIATE POSITION - ST AUGUSTINE, FL

A well-established, solo-physician in St Augustine, FL; is seeking a full-time associate. Applicant should be well-trained with sound surgical skills, applicant must be board eligible/certified. Practice offers a state-of-the-art practice setting, with a good general mix of all aspects of podiatric medicine and surgery. Competitive salary. E-mail resume to:  drfootwound@gmail.com

ASSOCIATE POSITION - BOSTON/CAPE AREA

Boston/Cape Area Practice looking for physician experienced in surgical and medical care in office, clinical, and nursing home settings. Practice will provide opportunity to utilize training immediately. Both surgical and non-surgical applicants. Email CV to: drjaa@verizon.net

ASSOCIATE POSITION- WASHINGTON

A well-established practice with 4 locations in and around Seattle is seeking a full time/part-time associate podiatrist. Position involves clinical, nursing homes, laser therapy. Applicant should be well trained physician and a motivated, energetic self-starter, completed minimum a 24-month residency. Please send inquiries to: isbinc2006@gmail.com

ASSOCIATE POSITION - WORCESTER MASSACHUSETTS

Podiatry practice in Worcester Massachusetts is looking for an associate podiatrist. Busy 2-person practice. High surgical numbers. No nursing homes. Call to hear free recorded message for more information. Call 641.715.3800 Access Code 32299 and message 4 to learn about the practice. Visit our website www.centralmasspodiatry.com

ASSOCIATE POSITION - OHIO

Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO- 2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to: Ohiopodiatrist@aol.com

PM News Classified Ads Reach over 13,500 DPM's 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 13,500 DPM's. 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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