The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

August 01, 2007 #3,003 Editor-Barry Block, DPM, JD

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NY Podiatrist Provides Advice For Summer’s Sweaty Feet

Sweaty feet and infections pose a problem in the summer heat. "Wash your feet at least once a day in hot weather. Open shoes mean your feet attract a lot of street dirt," says New York podiatrist Dr. Jeffrey Adler. "I like Dial soap. It's antibacterial and antifungal," he adds. "All types of iodine-type products are also helpful. Make sure you moisturize with an aloe-based moisturizer, because aloe absorbs better than almost anything.

Dr. Jeffrey Adler

"Skin should feel supple, not greasy. Moisturizer should be absorbed, not sitting on the surface." While sticking to natural-fiber shoes and socks helps feet breathe, "excessively sweaty feet may be indicative of a medical condition that can be treated with medication," says Adler. Bacteria thrive in warm weather, so inspect your feet regularly for signs of infection. "Make sure there's no cracks or irritation, check between your toes," he advises.

And, if you do find something unpleasant lurking, don't self-diagnose. "Even I can't tell what kind of fungal infection someone has unless I take a sample," warns Adler. "There are about 10 common bacterial infections. I can't tell you how many times it turns out not to be athlete's foot."

Source: Eloise Parker, New York Daily News [7/29/07]

CMS Extends Deadlines for the Competitive Bidding Program

The Centers for Medicare & Medicaid Services (CMS) is extending the bid submission, registration, and accreditation deadlines for the first round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program.

Please note: All bids are now due by 9:00 p.m. prevailing Eastern Time on September 25, 2007. Suppliers that have already submitted their bids may revise and resubmit their bids until the new deadline. Suppliers that resubmit bids must submit a new certification statement.

Suppliers interested in bidding must first register and receive a User ID and Password before they can access the internet-based bid submission system. Registration opened on April 9, 2007. The original registration deadline was June 30, 2007. CMS has reopened registration. The registration deadline is now August 27, 2007.

Suppliers must be accredited or be pending accreditation to submit a bid and will need to be accredited to be awarded a contract. The accreditation deadline for the first round of competitive bidding was originally August 31, 2007. The accreditation deadline is now October 31, 2007.

Source: CMS

Mummy May Prove That Prosthetics Go Back to 1000 BC

When this mummy lived, she was able to walk like an Egyptian—thanks to a false toe. The toe, made of wood and leather, may be the world's earliest known functional prosthetic, experts say. The current earliest known prosthesis is an artificial leg found in Italy that dates back to 300 B.C. That's several hundred years younger than the Egyptian toe, which dates to between 1000 and 600 B.C.

Photo Courtesy of Jacky Finch

A woman between 50 and 60 used the well-worn prosthetic, and the amputation site of her toe seems to have healed successfully, Jacky Finch, of the University of Manchester in the United Kingdom, said in a statement. To see if the toe really works, Finch is gathering a group of volunteers who have lost their right big toes to wear a replica of the Egyptian toe.

Finch will also test a second Egyptian prosthetic toe from the same time period. That toe, made of a sort of papier mache, is on display at the British Museum. Replicas from both toes will be tested at the Human Performance Laboratory at the nearby University of Salford. "If we can prove that one or both were functional," Finch said, "then we will have pushed back prosthetic medicine by as much as 700 years."

Source: Christine Dell'Amore, National Geographic [7/27/07]

Query: Grafting Materials for Venous Stasis Ulcer

I was curious if anyone has found more success with any of the grafting materials or wound care products over others, specifically for venous ulcers? (e.g., Apligraf, Gammagraft, Dermagraft, etc.) I have a patient with a long-standing venous ulcer that is recalcitrant to any prior treatments, the ulcer was biopised to ensure no malignancy and findings were consistent with stasis ulcer.

Jeffrey Kass, DPM, Forest Hills, NY

Query: Intralesional Steroid Injection

What is the appropriate CPT code for an intralesional steroid injection for treatment of psoriaforme dermatitis in the foot?

Glenn Weinfeld, DPM, Cortlandt Manor, NY

Response: Take a look at CPT 11900 Injection, intralesional; up to and including seven lesions.

CPT® Assistant September 2004 Volume 14 Issue 9

"AMA Comment: Codes 11900, Injection, intralesional; up to and including seven lesions, and 11901, Injection, intralesional; more than seven lesions, are intended to treat lesions of the integumentary system—such as keloids, psoriasis, acne (cystic or nodular), and others—by injecting drugs directly into the lesion itself. It would not be appropriate to report codes 11900-11901 per injection as the code descriptor identifies the number of lesions treated, not the number of injections, per se. Code 11900 should be reported once, when one to seven lesions are treated, even if a particular lesion is injected more than once. Code 11901 should be reported only once to indicate the treatment of eight or more lesions. Therefore, code selection should be determined by the number of lesions treated, not by the number of injections."

CPT® Assistant May 1998 Volume 8 Issue 5

"From a CPT coding perspective, codes 11900 and 11901 do not include the medication. These codes are for the injection only. It is appropriate to report the medication in addition to codes 11900 and 11901 with either the appropriate J-code or 99070."

Margie Scalley Vaught. CPC, CCS-P, Chehalis, WA

RE: Billing Software ( Ian S Goldbaum, DPM)
From: Multiple Responses

We have been using a web-based program for about a year now with success. Advantages are being able to access your billing from any computer as long as it has high speed connection. The monthly fee is reasonable and it has scheduling software as well as EMR built into the program. Try www.webedoctor.com

Ira Weiner, DPM, Las Vegas, NV, vegasfootdoc2005@yahoo.com

Sammy 2000 in my opinion, is the best there is. Many of my colleagues as well as some MD s currently use it .They are more than satisfied. Their support is incomparable!

Marc Bendeth, DPM, Hewlett, NY, mbendeth@optonline.net

I have been using DB software since it was developed. They have been very responsive whenever a problem existed, the program includes electronic billing directly to Medicare and Medicaid, and has been very efficient.. I recommend it very highly. My rejection rate is almost zero

Edward Epstein, DPM, Bradford, PA, epstein@atlanticbb.net

One of the best overall programs I've used in terms of ease of use, learning curve, product support and features is "AppMed" software. They are used nationally by a number of specialties, but podiatry is a field they are VERY familiar with. Contact Jeff or Lisa Stoy, AppMed, Inc., Lindenhurst, IL (847) 245-4100 or (800) 854-0031 (www.appmed.com)

David Hettinger, DPM, Wheaton, IL, davidhett@msn.com

I recently switched from 10 years of a billing service to EBS billing software. Best thing I've ever done.

Frank Lattarulo, DPM, New York, NY, DOCLATT@aol.com

NEW JERSEY - OCEAN COUNTY - IMMEDIATE OPENING!

Part time associate wanted. Tentative hours: Tues - AM, Thurs - PM, Sat (every other) - AM Definite growth potential. Looking for an ethical and conscientious practitioner. Competitive salary with incentives. Great working environment! Please fax CV to:(732) 695-0223 or e-mail to shorepodiatry@aol.com

ASSOCIATE POSITION - NORTHWEST PENNSYLVANIA

Multi-specialty group is looking to add another Podiatric Surgeon or General Podiatrist to our well-established group. Office locations in northwestern Pennsylvania. Unlimited opportunities exist for the right Associate, wound care experience is a plus. Please forward your CV to adminsec@ips-mso.com

ASSOCIATE POSITION – PART TIME - BRONX, NY

Part time associate position available in the Bronx, NY. Two days a week. 30K/yr + incentives. Full-time position may be available shortly. Must be ethical, hardworking, and Spanish speaking a plus. Please email resumes to Scottdeis@aol.com

ASSOCIATE- SOUTH JERSEY

PT/FT wanted for progressive (EMR, Digital x-ray, Diag U/S ), ethical, full scope group practice. A motivated team player with very good surgical and routine skills. ABPS cert and 24/36 PSR preferred but will take experience into consideration. Located between Phila. and the shore. A very fair benefits /compensation package. CV and references Toetrukr@aol.com

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 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

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