The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

July 11, 2007 #2,983 Editor-Barry Block, DPM, JD

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NY Podiatrist Uses Hydrofera Blue for Pressure Ulcers

Mark Gventer, DPM, of Sheepshead Bay, NY, has found a new breakthrough treatment for complex wounds, such as pressure ulcers, with tremendous success. Using Hydrofera Blue and proper wound care, he has healed such patients as Joseph Brekhman of Bensonhurst, an 82-year-old diabetic who had the second toe on his right foot amputated due to gangrene, a common problem of older diabetic patients. Brekhman also had extensive ulcers on and between his toes, as well as on his heel and back of the foot—some of which were up to 1 cm. in diameter and 2 mm. deep.

Dr. Mark Gventer

“I’ve used Hydrofera Blue on several patients because it’s easy to apply and promotes drainage, acting as a mini-vacuum system,” Gventer said. “In addition, Hydrofera keeps the wound clean, and provides a moist healing environment. Once the ulcers show areas of healing tissue, I often use Hydrofera Blue along with Regranex to treat them.”

Source: Brooklyn Daily Eagle [7/10/07]

NYCPM Participates in 6th Annual West Point Cadet Boot Fit

On July 3rd and 5th, six faculty members from the New York College of Podiatric Medicine (NYCPM), assisted by eighteen third- and fourth-year students, worked feverishly to fit the more than 1,300 new cadet candidates of the U.S. Military Academy at West Point with properly-fitting boots. The NYCPM volunteers identified cadet candidates with a variety of pre-existing problems, ranging from blisters to bunions, hammertoes and other conditions, and referred them to their company medic. Cadets found to need special boot accommodations were referred to the Academy’s orthotist.

NYCPM Students Fit West Point Cadets

“We deeply appreciate the New York College of Podiatric Medicine’s involvement in helping to prepare our incoming cadets,” said Lt. Col. Duffy. “Since NYCPM started this volunteer program of foot care for our new cadets, injuries such as stress fractures and infections have been reduced by seventy percent. And boot returns and blistered or injured feet are no longer a major problem for us.”

The NYCPM students who participated in the Boot Fit, under faculty supervision, were Nicholas Argerakis, Diane Castro, Rick Chen, Christina Hamad, Lee Hlad, Meejin Kim, Samir Lalani, Brad Levitt, Jose Paul Loor, Sadia Mahmood, Daniella McKenna, Hirunnisha Najjar, Heidi Newkirk, Rupal Oza, Dolly Raihl-Stelzer, Jeff Robertson, Vishnu Seecharan, and Rawle Shewprashad

Medicare Announces New Clinical Trial Policy

The Centers for Medicare & Medicaid Services (CMS) announced today its revised clinical trial policy national coverage determination (NCD) which addresses Medicare coverage when beneficiaries participate in clinical research trials.

CMS published its proposed Clinical Trial Policy Decision Memorandum on April 10, 2007. Based on the public comments received regarding the proposed decision, CMS became aware of differing views regarding the existing and proposed clinical trial policy. Based on these comments, CMS has modified its proposed Clinical Trial Policy NCD. In this revised policy, CMS may determine that an item or service is only reasonable and necessary in a clinical trial — an option that CMS has previously defined as Coverage with Evidence Development.

In addition to the final decision on the current reconsideration of the clinical trial policy, CMS is also announcing that it plans to reopen the Clinical Trial Policy NCD and post a new proposed decision memorandum for a 30-day public comment period. The proposed decision memorandum will build upon the extensive public comments already received.

Source: CMS

Query: Coding the Removal and Insertion of Hardware

The doctor did a hammertoe correction of the 2nd toe with screw fixation. Three weeks later he had to remove the screw, which was backing out, and then inserted a K-wire, using a K-wire driver.

Would I code a CPT 20670 with a "-78" modifier only for the removal of the screw? The head of the screw was breaking through the skin, so it was easily removed.

Is there a procedure to bill for the insertion of the K-wire, or would this be covered under the intial CPT 28285 performed as the original procedure?

Patti Smith, Lake Havasu City, AZ

Response: Insertion of internal fixation (e.g., screw, K-wire, etc.) is generally included in the allowance of the original procedure, and not paid separately.

Tony Poggio, DPM, Alameda, CA

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RE: John L. Bennett (7/10/07]

I met John Bennett in 1975 as he was the Executive Director of the ABPS. I was sitting for its first examination, and after I completed the test, I was very concerned about whether or not I passed it. I had a conversation with Mr. Bennett about this.

Approximately six weeks after that I got a telephone call from John Bennett from Chicago, informing me that I did pass the exam. Needless to say, I was thrilled about the results of the test and told Mr. Bennett (call me John) just how much I appreciated him taking his time to call me. He didn't have to do that he said, but he remembered my concerns and knew I would be glad to hear the good news. He was so right. Thank you John, I will never forget your kindness.

Jerry Tirsch, DPM, Chatsworth, CA

RE: OIG and NPWT (Paul Kesselman, DPM, 7/10/07)
From: Lloyd S. Smith, DPM

I find the review by the OIG on pumps fairly tame. I have read other reports on other subjects that are much more strident. It is also interesting to note that the OIG reports are simply reports and not directives to CMS or anyone else. They carry weight but the agency being reviewed can reject the findings. CMS did so with some of the findings.

The entire area of wound care has received a high level of scrutiny because of the booming reimbursements for many new supplies and services.

Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

RE: Using the Term Medical Doctor (Daniel Chaskin, DPM, 7/9/07)
From: Gerald Mauriello, Jr., DPM, MA, Gerald Peterson, DPM

Do dermatologists practice dermatologic medicine? Do psychiatrists practice psychiatric medicine?, Do orthopedists practice orthopedic medicine? No, this is ridiculous!

When I treat athlete’s foot, a fracture, a Charcot joint, a chronic wound, I practice medicine. Just like any doctor treating these pathologies, I employ the same evidence-based techniques and methods. There is no special mysterious podiatric medical technique. A doctor is a doctor.

Gerald Mauriello, Jr., DPM, MA, Jamaica, NY, mauriellodpm@gmail.com

This should not be a question anywhere in the US. We, as Dr. Niewenhuis so aptly put, are podiatric physicians. This was our degree conferred on us at graduation. This has also been in the "news" in our political arena and in the APMA News, I believe, in letters to the editor for years as well. Be proud of who you are!

Gerald Peterson, DPM, West Linn, OR, Blkjck@ifixft.com

Editor’s note: This topic is now closed.

PODIATRISTS NEEDED - CHICAGO AND NW INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax 773-486-3548 www.homephysicians.com sschneider@homephysicians.com

ASSOCIATE POSITION – BOSTON, MA

20 year old, well established, modern practice with 2 locations just out of Boston, looking for associate, P/T or F/T, motivated 24/36 trained or ABPS-Certified or eligible to start immediately. Strong surgically-based practice. Looking for motivated individual, able to practice all facets of podiatry practiced. Electronic scanning for orthotics and voice activated EMR already in office. Fax CV to (617) 567-0822

ASSOCIATE POSITION FLORIDA - NORTHEAST REGION

Busy, well established, full scope podiatry practice seeking highly motivated, hard-working, reliable, responsible and especially likeable to the average human, Associate. Surgical training a plus. Prefer PPMR or RPR. This is an Associate position with lots of potential. Team players only. Email CV to: healthparkmgr@bellsouth.net or fax CV to: 904-826-1586

EQUIPMENT FOR SALE-CENTRAL NJ

Boyd chairs(3), x-ray processor, view boxes, densitometer and much more all in working order. smaller items can be shipped chairs to be picked up please call me at 908-730-8881 or contact me at larrydpm2002@yahoo.com

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PRACTICE FOR SALE - NORTHERN CALIFORNIA

Great opportunity to own a well-established turn-key podiatry practice located in modern medical office building in East Bay; Electronic billing, good payor base, no HMO contracts; Biomechanics, general podiatry with great potential for surgery. Please send CV and letter of interest to: norcalpod@hotmail.com

ASSOCIATE POSITION – SOUTHERN CALIFORNIA

Seeking a position in a warm, friendly, and productive environment? Well, look no further! A well established podiatry facility in North Hollywood , California has an immediate position available for a podiatrist. He/She must be motivated, reliable, and dedicated. Depending on performance, partnership is possible. If interested, email your resume to drnickoghosyan@yahoo.com

ASSOCIATE POSITION - MIAMI BEACH, FL

Seeking well trained PMS 36 / PSR 24+ for Full-Time associate position. Leading to partnership for the person. practice is 50% hospital based. Must have strong Sx skills, including Limb Salvage & Trauma. Competitive Salary & benefits Package. Fax 305-652-6672 or Call 305-785-2559 Email: doctorsole@aol.com

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