The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 23, 2011 #4,214 Publisher-Barry Block, DPM, JD

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NY Podiatrist Discusses Cosmetic Surgery Options

Dr. Suzanne Levine, a New York based podiatrist, said that burning soles are the top concern for her pump-loving patients. To remedy this, she trademarked a procedure called “Pillows for Your Feet,” which involves injections of polylactic acid to combat the loss of cushioning on the balls of the feet. Levine, who co-chairs an organization called the International Aesthetic Foot Society, also offers cosmetic services, such as a 45-minute “foot facial."

Dr. Suzanne Levine

And for women whose uneven toes make it difficult to wear snug-fitting stilettos, Dr. Levine said that Botox may be used to straighten the big toe. “When you have the abductor tendon moving the big toe toward the second toe, you can use Botox to weaken that muscle,” she explained. “There are some people who say, 'As long as I’m able to wear my high-heeled shoes, I’ll do anything,'” Levine said. “There is a status that’s involved with the kind of shoe you’re wearing, more so than clothing.”

Source: Erin Clements, Huffington Post [7/20/11]

NYCPM Student and Physical Therapist Conduct Workshop for Dance Company

This July, the Paul Taylor Dance Company hosted a summer intensive for dancers at La Guardia High School to foster this ideal in young aspiring dancers. Along with technique and performance classes, the students also had an opportunity to learn about the various aspects of dance medicine and how dancers can better take care of their bodies.

Alicia Attanasio and Greg Taylor with Paul Taylor Dance Company (Photo Greg Taylor)

The presenters at this workshop included NYCPM’s physical therapist, Greg Taylor and third-year student Alicia Attanasio. In an entertaining and informative manner, Greg and Alicia addressed the unique demands of dancers and helped them to understand what is necessary for them to maintain their dance health. Greg presented the fundamentals of physical therapy, with an interactive anatomy review. Alicia discussed the various aspects of podiatric medicine, injuries of the lower extremity and even was able to give the dancers an introduction to the gait cycle and its assessment.

Source: Alicia Attanasio, NYCPM Student Alumni Report [Summer 2011]

IL Podiatrist Arrested in Alleged Healthcare Fraud Scheme

The owners of a suburban home healthcare business and a suspended podiatrist were arrested Wednesday and charged with illegally accepting more than $1.5 million in fraudulent Medicare payments and trying to illegally obtain a work visa for one of the owners. Federal agents executed a search warrant at House Call Physicians in Palos Hills on the same day the owners, Bahir Haj Khalil and Mohammed Khamis Rashed, were arrested and charged, along with Dr. Paschal U. Oparah, in a two-count criminal complaint unsealed in U.S. District Court, according to the U.S. Attorney's office.

According to the complaint affidavit, the healthcare fraud scheme involved billing for services as if they were performed by physicians, when in fact, they were performed by physician assistants. It aso included billing for podiatry services as if they were performed by a licensed podiatrist, when in fact, they were performed by Oparah, whose license was suspended.

Source: Sun-Times Media Wire [7/20/11]

Dress in Your Team Uniform

Dr. Scott Aronson and office TEAM in Stoughton, MA when Bruins won the Stanley Cup.

Always on the lookout for an opportunity to WOW patients and give them a reason to speak about you with friends, family and co-workers. Next time one of your local professional sports teams is in the finals or playoffs, a neat idea is to have all in your office wear a jersey or shirt of your local team on select days during the playoffs and championships.

Source: Hal Ornstein, DPM

Query: Hemostasis

Besides Lumicaine, are there any other topicals or methods to use when a patient bleeds from a nick, etc. when cutting nails, etc., especially someone on Coumadin or ASA therapy?

Ivar E. Roth DPM,MPH, Newport Beach, CA

Query: Duty to Report G Code

If you have a certified EMR such as TrakNet and the eRx is being used,  will we still have to report the G code?  My office manager says that whenever we write an eRx from this certified program, the software keeps note of that for Medicare.  

Kevin Lam, DPM, Naples, FL

Query: Employee Working at Home Under HIPAA

The person who did the billing in my office asked if she could do the billing at home on her own computer. This way she could do the work at leisure at night, and get another job in the daytime. Would there be problems with HIPAA compliance? I would have no control over who would access or see that information.
 
Elliot Udell, DPM, Hicksville, NY

Editor's Comment: PM News does not provide legal advice. HIPAA requires that you take "reasonable" steps to protect PHI. This means that the employee's computer would need to be password-protected to ensure that others living or visiting the home could not access PHI, (which is sometimes difficult in a family environment). The computer would also need to have an automatic screen saver that activated after a short period of non-use to prevent unauthorized viewing. If you choose to do this, have the employee sign a confidentiality waiver stating that she is liable in the event of a confidentiality breach.

Query: Comparing Education and Training of "Podiatrists" from Different Countries.

In reading articles in the JAPMA and other publications, and having discussions with foot doctors from other countries, I detect vast differences in our education and training. In the USA, we have the standards developed by the Council on Podiatric Medical Education. Does anyone know of a comparative study as to the education and hands-on training in other countries (pre-requisites, pre-med, podiatry college, post-grad courses, hours, etc.)?

Robert Scott Steinberg, DPM, Schaumburg, IL

Query: Bunionectomy Coding

I recently performed a hallux valgus correction (bunionectomy) which encompassed an opening wedge osteotomy of the first metatarsal base, closing wedge of the metatarsal head for PASA correction, and an Akin-type osteotomy. In effect, this is a bunionectomy with a "triple osteotomy." Is there a better way to code this other than CPT 28299 (bunionectomy with double osteotomy), which neither accurately describes the procedure nor reflects the work done?

Jon Strickler, DPM, Cleveland, TN  

Response: You code based on what was done and what CPT makes available to you. In your case, the following CPT codes should be used with the following ICD-9 codes:

1) CPT 28299 - correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy  ICD-9 735.0 - hallux valgus; ICD-9 736.70 - deformity of ankle and foot, acquired

2) CPT 28310- osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)
ICD-9 735.8 - other acquired deformities of toe

The second CPT code is designated a "separate procedure". You must meet the CPT definition of separate procedure. I am providing the following information to make sure you satisfy the rules used by CMS and most payers. If a CPT code descriptor includes the term “separate procedure”, the CPT code may not be reported separately with a related procedure. CMS interprets this designation to prohibit the separate reporting of a “separate procedure” when performed with another procedure in an anatomically related region, often through the same skin incision, orifice, or surgical approach.

A CPT code with the “separate procedure” designation may be reported with another procedure if it is performed at a separate patient encounter on the same date of service or at the same patient encounter in an anatomically unrelated area often through a separate skin incision, orifice, or surgical approach. Modifier "-59" or a more specific modifier (e.g., anatomic modifier) may be appended to the “separate procedure” CPT code to indicate that it qualifies as a separately reportable service.

Please make sure that CPT 28310 meets the requirements outlined for you here that will be evident by your operative report.

David J. Freedman, DPM, CPC, Silver Spring, MD

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: TrakNet Users Group Formed
From: Samuel R Galitzer, DPM

A new forum, not affiliated with Traknet, has been set up to better enable practitioners to assist each other. This forum will enable us to get ideas from each other  that are specific to the Traknet user community. The forum will be available for users to answer each others' questions. Also, this forum will be a place where suggestions can be made for enhancements to the program. To join the group go to  groups.yahoo.com/group/TraknetDPM

Samuel R Galitzer, DPM, Greenbelt, MD, Sam@galitzer.com

RE: Medicare Number and Moving (Mike Piccarelli, DPM)
From: Pete Harvey, DPM

If you allow Medicare direct deposit, then your address change should not affect your Medicare deposits unless you also change banks.

Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

ASSOCIATE POSITIONS - NW INDIANA

2 Full-Time positions open - One for Northwest Indiana. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION – NEW YORK

Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. E-Mail CV to jermaire@aol.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, Metroplus, and other Medicaid plans. Preferably a Spanish-speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

TURN-KEY PODIATRIC OFFICE - CALIFORNIA

Fully equipped modern suite with built-ins at Mission Regional Medical Center, Mission Viejo CA. Four treatment rooms, New Midmark chairs, x-ray/processor, phone system & much more. $45,000/assume lease. Call Jackie, 949-493-8020.

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

RESIDENCY OPPORTUNITY - MASSACHUSETTS

Mount Auburn Hospital, a teaching hospital of Harvard Medical School (HMS), Cambridge, MA is immediately seeking candidates for a new CPME approved three-year residency in Podiatric Medicine and Surgery Residency (PMSR) with additional Reconstructive Rearfoot and Ankle (RRA) credentialing. The emphasis of this PMSR-RRA well-rounded high volume program includes surgery (particularly complex reconstructive forefoot, rearfoot, and ankle surgery, sports medicine, and trauma), academics, and research. Interested applicants should immediately contact Emily A. Cook, DPM, MPH, CPH atMAH.Residency@gmail.com. Candidates must: start October 1, 2011, have completed a podiatric doctorate, passed parts 1 & 2 of the NBPME.

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