The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

July 27, 2007 #3,000 Editor-Barry Block, DPM, JD

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PM News Publishes 3,000th Edition

This marks the 3,000th issue of PM News. For over 13 years, it has been our privilege to provide the podiatric community with a daily newsletter containing news, coding and billing information, as well as an interactive forum for a discussion of issues important to this profession. In short, we have attempted to keep everyone on the same page. We are proud to be the longest running periodical of this type serving any profession.

PM News Editor Dr. Barry Block

We would like to thank all those who have made this endeavor a success, especially our readers, who have provided us with a continuous stream of provocative questions and informative responses. We’d also like to thank our strategic partner Codingline.com (Harry Goldsmith, DPM) and our webmaster Al Musella, DPM for their vital daily assistance. Finally, we’d like to thank our many sponsors for their continuous support.

IA Podiatrist to Head Amputation Prevention Center

Broadlawns Medical Center is opening an Amputation Prevention Center. Dr. Lee Rogers, a leading expert in surgical limb salvage, will head the new specialty center.

Dr. Lee Rogers

The center will offer inpatient and outpatient services and will focus on medical and surgical services to help prevent limb loss. Rogers graduated from the College of Podiatric Medicine and Surgery at Des Moines University. He completed his residency in podiatric medicine and surgery at St.Vincent Catholic Medical Centers in New York City. He was previously with the Center for Lower Extremity Ambulatory Research at Rosalind Franklin University of Medicine and Science in Chicago.

Source: Des Moines Register [7/25/07]

NYCPM Sends Two Faculty Members to Assess Boot Fit at Marine Corps Base

In mid-July, at the invitation of Brigadier General James B. Laster, Commanding General of the United States Marine Corps Training Command, an assessment team from NYCPM visited Officer Candidates School (OCS) at the Marine Corps Base in Quantico, Virginia to observe and to make recommendations for process improvement to existing OCS in-processing and boot fitting procedures.

Dr. Robert Eckles

The NYCPM assessment team included the Hon. Joseph Lisa, a retired State Supreme Court judge and retired Marine Colonel who was instrumental in setting up the visit and who served as the liaison with the Corps, and NYCPM faculty members Robert A. Eckles, DPM, Dean of Clinical Studies and Graduate Medical Education, and Russell G. Volpe, DPM, Professor of Orthopedics and Pediatrics. Drs. Eckles and Volpe have both been actively involved for the College in the ongoing Boot Fit program at West Point.

Dr. Russell Volpe

The goals of the assessment visit, which was hosted by Colonel Richard Mancini, the Commanding Officer of the OCS, included identifying how boot fit services currently provided by NYCPM to the incoming cadets at the United States Military Academy at West Point could be adapted to fit into the in-processing schedule at OCS.

Query: Circulator Boot

One of my patients has severe inoperable peripheral vascular disease with osteomyelitis and some gangrene. He is now going to a clinic three times a week and having a physical therapeutic treatment with a device called the "Circulator Boot." The company and clinical proponents claim that this modality can actually improve collateral circulation. Does anyone have any clinical experience with this modality? If so, what have your outcomes been? Under what circumstances would you refer a patient for this treatment, and under what circumstances would you advise a patient not to seek this type of therapy?

Elliot Udell, DPM, Hicksville, NY

Query: Coding For an Assistannt Surgeon

Is there a difference in coding for an assistant surgeon for a procedure(s) using the "-80" modifier vs. using an "8" designation for type of service on the CMS 1500 claim form?

Oliver Zong, DPM, New York, NY

Response: "Is there a difference in coding for an assistant surgeon for a procedure(s) using the -80 modifier vs. using an 8 for type of service?"

Yes, they served wholly different purposes. The "-80" modifier deals with a claim for payment (Field 24D) for the assistant surgeon while the type of service (Field 24C) numeric designation had been for payer use in determining either which contractor the claim should be processed through if the payer was Medicare and/or for the purpose of gathering data on types of services claimed.

As of July 1 (2007), with the obligatory use of the new CMS 1500 claim forms, Field 24C is no longer the field for listing the type of service - payers no longer require this. Field 24C now is labeled "EMG" (which on the previous form was located in 24I). "EMG" stands for "emergency," and should only be completed (by entering a "Y") when there is a need to indicate an emergency service was performed.

Harry Goldsmith, DPM, Cerritos, CA

Codingline subscription information can be found at http://www.codingline.com/subscribe.htm

RE: Os Trigonum Syndrome and Neuritis ( Charleen Handzel, DPM)
From: Multiple Respondents

Make sure the orthotics are contoured closely to the patient's foot in subtalar neutral and midtarsal locked and the proper amount of balance (in your patient's case 0 degrees) has been included in the orthotic. Also make sure the patient's shoes are stable.
Arnold Ross, DPM, Los Angeles, CA, asross1@juno.com

Before you treat any further and delve into all kinds of orthotic adjustments and the like, how sure are you of your diagnosis? Multiple joint symptoms, including spine involvement, with polyneuritis and what may actually be an occult enthesopathy, sounds very much like an inflammatory arthritic process. Of course, being a competitive athlete, she may have injured each one of those areas on separate occasions. Any chance, in the absence of multiple traumas, that an underlying collagen vascular disorder or DISH exists? What's the girl's family history? Was a CVD screen ordered? Would also work her up for exercise induced compartment syndrome, but my suspicion is the recent neuritis is somehow linked to the joint involvement.

Barry Mullen, DPM, Hackettstown, NJ, YAZY630@aol.com

I have found that these patients do better with orthotics that have a deep heel cup, are semi flexible, however they need the rearfoot to have a ZERO degree post so they do not any tendency to roll to the lateral portion of the foot and place more tension and pull on the peroneal tendons. You may also want to add a lateral heel clip as well. Should there be a forefoot deformity, the forefoot post is better off extending to the sulcus as opposed to the met heads. I still recommend extrinsic forefoot posting with a medium density posting material.

Steven Goldstein, DPM, Wayne, NJ, stevefootdr1@cs.com

RE: PM News To Mark Issue #3,000
From: Multiple Respondents

WOW....I, for one, was not aware of that incredible upcoming milestone, and thank you for the Wake-up call !! Dr. Block certainly is multi-talented....and has provided a service to our profession that is a toe-tally tremendous feet (oops...feat) !! Congratulations, and keep up the great work Barry...it's something we all look forward to on a daily basis!!!

Art Gudeon, DPM, Rego Park, NY

Congratulations Barry, on another major milestone with the publication of your 3,000th issue of PM NEWS. . in addition to your countless other contributions to the profession! These are towering achievements. With all good wishes for continued success.

Bob Levoy, Great Neck, NY

Congratulations to Dr. Block on the 3,000th issue of PM News! I also want to congratulate him on his recent APWCA award. Barry, you are very appreciated for all that you have done and continue to do for the profession of podiatry and all of its members and affiliates.

Jonathan B. Purdy, DPM, New Iberia, LA

RE: Charles Fusilier, DPM

I had never heard of "Chuck, the foot doctor", Charles Fusilier, DPM, before the announcement of his passing in PM. I have had the opportunity of meeting some DPMs with the most lucrative practices in existence currently, those that have amassed fortunes, owned part of professional sports teams, etc. But my heart and soul is moved much more in the memory of this esteemed colleague who gave of himself in caring for others and truly changed lives without regard for being monetarily rewarded.

Michael Lawrence, DPM, Chattanooga, TN

RE: 2 Vs. 3 Year Residency (Jeff Merrill)
From: Allen Jacobs, DPM

3 years, if possible, is preferable IF the individual is desirous of a surgically oriented practice. The graduates of programs such as West Penn (3 YEARS) seem to accomplish a great deal, are readily accepted into multispecialty and orthopedic groups, and are leaders of our profession. 2 years is fine for a good general podiatry practice, such as I enjoy.

Things have changed for the better in our profession. With that said, legitimate arthroscopic surgery, serious external fixation, serious trauma management, major rearfoot/ankle reconstruction, requires a good 3 year residency. There is no substitute for experience and repetition.

Allen Jacobs, DPM, St. Louis, MO, Allenthepod@sbcglobal.net

Editor’s note: This topic is now closed.

ASSOCIATE POSITION - CONNECTICUT- HARTFORD

Connecticut Surgical Group, one of the largest multi-specialty surgical group practices in New England, is seeking a Board-Certified Podiatrist to add to our three-physician Podiatry division. This Podiatrist will provide all aspects of Podiatric care. We will consider candidates with 2- or 3-year training and who are ABPS-Certified/eligible. CSG is a highly-regarded practice in the Hartford Hospital medical community with an exceptional support structure and a strong referral base. We offer competitive salary and bonus, partnership opportunities, excellent benefits, and reasonable overhead. To apply, visit https://home.eease.com/recruit/?id=21426 or fax a CV to 860-524-2653. No phone calls. EOE

ASSOCIATE POSITION – MISSOURI

One of our long term associates needs to relocate due to family reasons. Step into full schedule. Five locations in growing population area without HMO's. Partnership available. Missouridpm@yahoo.com

PRACTICE FOR SALE OR LEASE- CENTRAL FLORIDA

Practice all phases. Wound care, hyperbaric privleges nearby. Excellent building, location, and exposure on busy highway. Outstanding place to live and work; low penetration by managed care. Ample parking and accessibility with 2,000 sq. ft building designed and equipped for podiatry (lease or buy) 7 minutes from hospital. Great price, terms and opportunity to grow. 352-357-7499 - windnwave@earthlink.net

ASSOCIATE POSITION -CONNECTICUT-NORTH HAVEN

Seeking a part-time associate for a busy, well-established, respected, growing practice. Desiring an ethical, motivated, personable, well-trained PSR12/24/ or 36 podiatrist. Our practice is well-rounded and diverse with a good mix of sports medicine, diabetic care, surgery, podopediatrics, and general podiatry. Email information and CV to Pedy7@aol.com with subject heading “Podiatry Associate.”

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE/OWNERSHIP GROUP PRACTICE- IMMEDIATELY - PHOENIX

Requires Arizona License NOW. Full scope of podiatry requiring usual skills in surgery and medicine. Once-in-a-lifetime financial opportunity for the right person. Practice has been established in the same location for over 25 years. SurgiCenter on premises and ownership included. Email CV and letter of intent to: PPRAC@cox.net

PODIATRISTS NEEDED - CHICAGO --NORTHWEST 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 ---------------------E-Mail sschneider@homephysicians.com -- www.homephysicians.com

ASSOCIATE POSITION-SOUTHERN CALIFORNIA

Full scope of podiatry. Requires usual skills in surgery, medicine and biomechanics. Must be self-starter and highly motivated. Two full days per week. May soon increase to three days per week. All billing and administrative aspects handled by staff. Can practice autonomously. footguy1@pacbell.net

ASSOCIATE WANTED - IMMEDIATE OPENING- NEW YORK

Associate Position with immediate opening in the Hudson Valley (NY) for multi-office well rounded podiatric practice including general podiatry, high volume orthotics, and reconstructive surgery. Looking for well trained (PSR- 24/36. Outstanding opportunity to work into partnership. Competitive starting salary, bonus incentives, benefits, and pension. PER DIEM also available for immediate placement. Please submit: CV, letter of intent and references to: footassociate@yahoo.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 SANTA FE, NEW MEXICO

Immediate opening for PSR 24/36 individual in three office practice. We are looking for an ethical, hard working, well trained Podiatrist. Partnership available. Please Fax CV to sfpodiatry@aol.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

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