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Serving Over 13,500 Podiatrists Daily

July 07, 2012 #4,508 Publisher-Barry Block, DPM, JD

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NY Podiatrist Provides Tips for Dry Skin on Feet

Save regular lotions for dry arms and legs -- most are not moisturizing enough for the tough skin on your feet, says NYC podiatrist Dr. Johanna S. Youner. Instead, slather on a thick cream with hydrating shea butter.

Dr. Joanna Youner

If you've got parched, cracked heels, you'll need an ointment containing acids (like salicylic or lactic) to break down dead cells, says Dr. Youner, who likes those from Kerasal.

Source: MSN Living [7/6/12]

NY Podiatrist Offers Shoe-Buying Advice

“I'm never surprised when patients tell me that they wear fashionable shoes that are uncomfortable,” says Dr. Paul Atlas, a podiatrist at Hudson Valley Ambulatory Surgery. “They’re not alone. According to a 2010 survey conducted by the American Podiatric Medical Association, over half of women experience foot pain, and two-thirds wish they felt more comfortable in shoes.”

Dr. Paul Atlas

“The obvious solution – wear low heels – is not very popular with our patients,” notes Dr. Atlas. “So my number one suggestion is to shop for shoes that are comfortable for your feet and to choose styles that don’t rub against or put pressure on your problem spots. If you can, also fit a cushioned insole under the ball of your foot to offer extra padding.”

Source: News Times.com [7/6/12]

Insurers Are Paying Claims Faster, But Are Denying More

Health insurers are paying claims more quickly and accurately than they did a year ago, according to the American Medical Association’s annual Health Insurer Report Card. But insurers also are increasingly requiring prior authorization and are denying more claims than they did a year ago, according to the report, which was released June 18.

All eight of the large health plan operators profiled in the report improved their first electronic remittance advice (ERA) accuracy over the past year, according to the AMA. The change could be tied to the Jan. 1, 2012 deadline to comply with updated HIPAA 5010 electronic transaction standards. Between 2011 and 2012, Anthem/WellPoint, Inc.’s accuracy percentage climbed from 61.05% to 88.59%.

Source: Steve Davis, Health Plan Week [6/25/12]

Healthcare Job Growth Slows in June

Healthcare added just 13,000 jobs in June, which was half of its average monthly growth rate in the past year but still comprised 16% of all new jobs in the national economy last month. Physician offices posted an overall loss of jobs, while hospitals showed a small gain.

Healthcare employment overall had one of its slowest months in a year, growing by 0.1% in June, according to seasonally adjusted figures from the Bureau of Labor Statistics. Monthly growth has been averaging 0.2% since June 2011. Physician offices lost 3,400 jobs in June. For the past year, the physician-office sector has been adding nearly 0.3% per month, but June saw a 0.1% loss.

Source: Joe Carlson, Modern Healthcare [7/6/12]

What Do Signs Say About Your Office?

Take a fresh look at the signs around  your office and ask yourself whether their tone reflects the attitude you want to convey to employees and customers. Are they friendly and polite or sarcastic and commanding? Martin’s Point Health Care in Portland, Maine, reinforces its vision statement, “People Caring for People,” with signs like these:

•  “Regrettably, I am not interruptible at this time.” Doesn’t that sound nicer than “Do Not Disturb”?
   
•  “If this pile is disappearing, please restock enough paper for 100 copies.”  That gives specific direction instead of just complaining “Don’t take the last copy.”

Source: Adapted from “Workplace Graffiti Can Be Detrimental to Your Culture,” Barbara T. Armstrong, Forbes, via Communication Briefings

Query: Dermagraft Denial

We have submitted claims to Connecticare for Dermagraft, both the application and the graft itself. Connecticare is paying for it as a DME item. We have tried explaining to them that this product is a graft, not a DME product. All to no avail. They advised us to appeal. We got all the information from Dermagraft to send in as an appeal. Any other suggestions from readers would be helpful.

Richard Feldman, DPM, West Haven, CT

Response: Technically, any hard item that you can put your fingers on is a DME item, so from that perspective Connecticare may be technically correct. However, the issue here is which contractor is to pay for it. In traditional fee-for-service Medicare, there are many exemptions to the DME MAC paying for a DME item. Examples of DME which come under the jurisdiction of the local MAC include, but are not limited to pharmaceuticals, joint implants, and skin substitutes.

Proof of this fact rests within both your local MAC's (NGS) LCD on skin substitutes, and within the NHIC (your local DME MAC) policy (chapter 12 of the supplier manual and Chapter 20 of the CMS Medicare Claims Processing Manual). ABH's customer service department should be able to provide you with these exact documents to forward to Connecticare. You might also attempt to speak with Connecticare's podiatric advisor and get CPMA involved in these discussions.

Paul Kesselman, DPM, Woodside, NY

Editor's note: Dr. Kesselman is a featured speaker (and available for your questions) at the Codingline-PM News Coding & Practice Management Workshop, August 20-22 (following the APMA Annual Meeting) at the Greenbrier -www.podiatrym.com/greenbrier.cfm

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APMA Members: Click here for your free Codingline Silver subscription

RE: Newton Running Shoes and Forefoot Pain (Pete Smith, DPM)
From: Brian W. Fullem, DPM

The Newton shoes have "lugs" in the forefoot to encourage a more midfoot strike. I run in them myself, and I love them, but they definitely can cause more pressure on the forefoot and lead to metatarsalgia. I recommend a Nike Free or one of the other minimalist type shoes. It will have a softer heel counter for the Haglund's deformity, and the lower heel height encourages less heel strike.

Brian W. Fullem, DPM, Tampa, FL, bfullem1@aol.com

RE: Amazing Charts (Gary A. Lieber, DPM)
From: Jordan Sheff, DPM

I've been using Amazing Charts EHR for about 3 years now. Initially, I was very happy, given the low, low cost of their system, but after three years, I've begun looking for other EHRs. Their "Guardian Angel" support is never available when you need them, and you have to leave a message and hope that they call you back soon - something very irritating when you have a major problem.

Another aspect that I do not like is the fact that their online backup, which I pay extra for, does not back up any of the imported data, i.e., x-rays, lab results, consult reports, etc. On the other hand, thanks to Amazing Charts, I did get the stimulus money everyone talks about, so I guess we take the good with the bad; nothing's perfect, right?

Jordan Sheff, DPM, Newport, RI, jsheff@newportfootcare.com

RE: Facebook Scam
From: Arthur Gudeon, DPM

Read the message below concerning a scam Facebook message from a purported NYCPM student, who ends up asking for money. Upon checking with Lisa Lee at NYCPM, she was found to never have been a student. Unfortunately, I see on FB that many DPMs HAVE already friended her, and are unaware of the situation. I tried to have FB warn them, but it doesn't seem to be working.
 
"Hello dear Arthur. I think we have things in common. I did not continue my podiatry education because I have to travel back to Ghana Africa as I lost my parents and did not have anyone to take care of my school fees. Hope to hear from you soonest as I have something important i will like to discuss with you." - Kathrine Rafael

Arthur Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com

RE: Unrestricted Medical Licenses
From: Leonard A. Levy, DPM, MPH

I am amazed about some DPM responses regarding my applause of the expansion of the practice act in New York State. One podiatric physician refers to “the lowly DPM” compared to the MD and DO. The scope granted to DPMs in all states certainly is not “lowly.” One DPM states that the “poor foot doctor” is limited forever without hope of increasing his training, having to “sue his way up the leg.” He refers to having to “sue” to expand our role to have responsibility for involvement in disorders of foot function due to disorders of the brain.

Indeed we have always had the right to diagnose, which encompasses detecting why foot function is impaired. That includes determining if a problem is local or even due to motor disorders that may have their etiology in the brain. Why else do podiatric medical students, well before entering residency, learn how to perform a...

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

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