August 02, 2006 #2,645 Editor-Barry Block, DPM, JD

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1) PM Podiatry Hall of Fame – If you haven’t reserved your tickets yet now is the time. All ticket proceeds ($45 per seat) go directly to the APMA Educational Foundation Student Scholarship Fund. Come see Dr. Warren Joseph honored (roasted) and have a delicious meal on Tuesday August 8th. You can reserve tickets by calling (800) ASK-APMA and asking for Tonia.

2) PM Annual Survey – We encourage you to take this survey at http://www.podiatrym.com Completing this anonymous survey provides us with valuable data, which we will publish in the February 2007 issue of PM. It also makes you eligible for valuable prizes, including a one-week Windjammer Caribbean cruise (value $2,000). Enter by sending Question #45 to bblock@podiatrym.com along with your name and address.

Link Between Radiation and Autoimmune Disease is “Red Flag”: ID Podiatrist

Federal scientists have uncovered a link between radiation exposure from a nuclear weapons plant and autoimmune disease. By extension, it is another indication of the dangers of the open-air atomic testing that rained fallout on Utah and throughout the United States. This is a "red flag" warning, said Dr. Peter Rickards, a Twin Falls, Idaho podiatrist who was involved in a federal study concerning the Idaho National Engineering Laboratory. It is interesting that they did find actually triple the rate" for autoimmune thyroiditis among men, he said.

Rickards is calling for the federal government to give documented downwinders, both in Utah and Washington, $500 vouchers for medical exams. This would be a "very inexpensive, efficient way to track the actual documented downwinders," he said.

Rickards warned that the study might turn out to be "just the tip of the iceberg" of autoimmune disorders among those exposed to radiation.

Source: Joe Bauman, Deseret Morning News [7/31/06]

NJPMS Announces New Officers to be Installed in October

On October 21, 2006, the New Jersey Podiatric Medical Society will install its new executive officers for 2007. The newly elected officers were announced by Rosario LaBarbara, DPM, Speaker of the House at the New Jersey Podiatric Medical Society’s House of Delegates meeting .

The new officers will include: Sharon M. Root, DPM, President, of Succasunna, NJ; Marc Haspel, DPM, President Elect, of Clifton, NJ; John DePalma, DPM, Vice President, of Medford, NJ; Steven Maffei, DPM, Treasurer, of Mercerville, NJ; and James Ricketti, DPM, of Hamilton Square, NJ.

“The membership of NJPMS can look forward to a year of high productivity and continued growth under the professional experience and dedication of its incoming leaders,” states Herman Hammerschmidt, NJPMS Executive Director.

Query: CME Cadaver Courses

I would like to know if there are any mini-residency or week long cadaver lab CME courses available. I am aware of the Podiatry Institute’s weekend course and attended this several years ago.

Harry Cotler, DPM, footdoc@gci.net

Query: Simple Debridement of a Wart

When a patient is being seen for treatment of a wart, if the doctor simply debrided the wart - much the same way as any other lesion would be debrided - would this be coded using the CPT 17000 (destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], all benign or premalignant lesions other than skin tags or cutaneous vascular proliferative lesions; first lesion) code series?

Are all warts, regardless of how they are treated (i.e., technique, greater or less time and effort, etc.), coded using the same series of CPT 17000 codes?

There is a lot of confusion in our office as to when to use the CPT 1700x codes. Some of our providers simply and quickly debride these lesion, and want to charge the CPT 1105x (paring or cutting of benign hyperkeratotic lesion) codes. Is this right?

Angela Gottbreht, CMC, CCP, Everett, WA

Response: Simple debridement is not a destructive treatment for warts. In fact, you would be very hard- pressed to link simple debridement alone as treatment of any kind for a wart. Usually debridement is performed in conjunction with a destructive procedure, or it is performed to "expose" wart tissue, or it is performed for some type of palliative relief from pressure pain - but it is not a destructive treatment.

Surgical curettement is an example of a CPT 1700x treatment method available. Surgical currettement must be destructive to the lesion (unlike simple debridement) with the wart being removed in toto with the curettement. Many providers apply chemocautery or laser or cryo to the site after surgical curettement to "ensure" (as best one can) destruction.

Your post does not mention or describe surgical curettement, just simple debridement. As such, in your example, CPT 1700x coding would be inappropriate. The appropriate code series to bill would be CPT 1105x (paring or cutting of benign hyperkeratotic lesion). This is a routine foot care code, and, unless the payer has a provision for paying palliative foot care, will be denied reimbursement.

Harry Goldsmith, DPM, Cerritos, CA

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

RE: Dermagraft is Back
From: Paul Kesselman, DPM

In the June 2006 Podiatry Management article on Human Skin Equivalents (HSE) I presented a very brief overview of Dermagraft, because it appeared at that time that this Smith and Nephew (S&N) product was to be discontinued. I have recently confirmed that S&N has successfully sold both Dermagraft and Transcyte to Advanced Bio Healing.

The sale of these products should not change the CPT coding from 15360-15366.

I would refer those who wish to continue to use these products to the spreadsheet within the Podiatry Management article for more information.

For more information on Advanced Bio Healing please call them at: (877) 422-4463
or visit their website at: http://www.advancedbiohealing.com

In addition, the CPT subcommittee’s findings on HSE will be issued in September of 2007. Watch for updates.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

ASSOCIATE POSITION- SOUTH CAROLINA

Associate position available in South Carolina south of Charlotte. Two office practice, with two podiatrists, in a growing area. Well-rounded practice with all aspects of podiatry. Opportunity for future partnership. Please send CV to cathykop@hotmail.com or fax it to 803-396-8657.

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. Perfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact ccipinc@ccipinc.net

PRACTICE FOR SALE - BERKELEY CALIFORNIA

Well-established office in professional medical building; Biomechanics, Geriatrics and General Podiatry; Excellent growth potential for surgery; Payor base MC, PPO, and self-pay (NO HMOs); Reliable referrals from local physicians; Electronic billing in-house; Transition terms negotiable. Send letter of intent to: foot4sale@sbcglobal.net

WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well-established podiatry practice in Mt. Airy, NC that is either for sale or in need of an associate/partner to come on board. Dr. Hodges unexpectedly passed away in January 2006, leaving approximately 3500 patients without a podiatrist. This is a unique opportunity to be able to work in an extremely busy practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

ASSOCIATE-PARTNER WANTED MICHIGAN-DETROIT AREA WESTERN SUBURBS

Great opportunity-must be hard working, reliable, responsible and good with patients & staff surgical training a plus-partnership after 1 yr. Michigan license required. Fax resume to 248-478-1370 Starting salary $200,000. plus benefits plus percentage. Serious inquiries only

FOR SALE MICHIGAN-DETROIT AREA

Michigan practice Detroit western suburbs for sale. 3 offices, great locations approx 1.5m gross, Buy outright or overtime. Call 561-213-9400 after 7:00 p.m. Serious inquiries only

ASSOCIATE POSITION- COLLEGE STATION, TX

Full time associate position for a surgically trained podiatrist to join an established growing practice in College Station, Texas. This is a great opportunity for a motivated individual to join the leading podiatry group in a family oriented growing community with a wholesome, small town atmosphere. Good package with opportunity for buy-in within two years. Please send CV to billglaze@brazosvalleyfootcare.com

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. 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 - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

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