The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

August 10, 2011 #4,229 Publisher-Barry Block, DPM, JD

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We encourage you to participate in this important survey at www.podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2012 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by sending Question #43 (no answer is necessary) to bblock@podiatrym.com along with your name and address.

Recent Advances in Orthotic Therapy

This week's prize is a copy of Recent Advances in Orthotic Therapy by Dr. Paul Scherer (Value - $129.95)..  

This is also your opportunity to vote for the next DPM and Non-DPM inductees into the PM Podiatry Hall of Fame.

NY Podiatrist Develops New Cosmetic Approach to Bunion Procedure

In the past, bunion removal was considered a functional foot procedure necessary to relieve the chronic pain bunions cause. According to Dr. Emanuel Sergi, a Manhattan podiatrist, today’s patients are also concerned with the overall look of their feet. In addition to eliminating the pain caused by bunions, there is an emphasis on making feet more cosmetically appealing. Sergi has developed a new procedure dsigned to produce both functional and cosmetic improvement.

Dr. Emanuel Sergi

Slimline Bunion Surgery™ provides patients with a better cosmetic outcome because it results in significantly less scarring than other techniques. Most traditional bunion removal techniques use a dorsal incision, resulting in permanent visible scarring on the top of the foot. During Slimline Bunion Surgery™, Dr. Sergi removes the bunion through a medial incision. According to Dr. Sergi, "A medial incision, which is an incision on the inside of the foot, results in fine to almost no scarring."

Source: GlobeNewswire [8/8/11]

MPMA Organizes Shoe and Sock Drive for Needy Children  

Members of the Michigan Podiatric Medical Association are teaming up with local non-profit groups to help families provide shoes for needy children. They're hosting a "new shoe and sock drive" to help the families.

Dr. Jeffrey Frederick

"We are partnering with 35 different locations across the state to have a shoe and sock drive. Parents are preparing children to go back to school but they may not be thinking of appropriate footwear. There are a lot of needy families out there," says Dr. Jeffrey Frederick, past president of the Michigan Podiatric Medical Association. Organizers are collecting shoes that fit kids in grades K through 8. They will then be handed out in the community.

Source: MyFox Detroit [8/7/11]

NC Podiatrist Pens Book About His Failed Run for Congress

Death of a Politician: One Man’s Run from Defeat to Victory documents one man's journey, highlighting his dream to become elected to the Congress of the United States. But this is more than a mere documentary chronicling random events of a political process. It is a story of Dr. Michael Wilson's personal fortitude, a display of character and commitment to a vision to succeed, even when the cards were clearly stacked against him.

Dr. Michael Wilson and His New Book

The strength of this story is how it moves seamlessly from one God-inspired moment to another, until his true destiny was realized. Never, ever giving up, the real prize was in discovering how faith in the power of God inspired him to greatness.

NJ Podiatrist's Late Daughter Continues To Inspire Students Through Scholarship

The second annual “Ilana Schuster Jonsson Scholarship,” was awarded at Montville Township High School on June 9.  Jonsson, a 1999 graduate of Livingston High School, had died in a fatal car accident on the Garden State Parkway eighteen months earlier.

Ilana Schuster Jonsson

The scholarship was established by her parents, Dr. Larry Schuster, a podiatric surgeon, and Dr. Ruth Schuster, a school social worker. “Through this scholarship, it is hoped that Ilana will continue in her goal to inspire students and remain a part of biology education at MTHS for years to come,” said her parents, adding that this scholarship night was especially poignant as the years pass and their daughter will no longer have the same direct and personal relationship with students who apply.

Source; Livingston Patch [8/7/11]

How Debt Deal Could Squeeze Medicare Pay Even More

The last-minute agreement that lawmakers and the White House reached to avoid a default on the nation's debt also considerably raises the stakes for physicians pushing for congressional action on Medicare payment before the end of the year.

The debt measure President Obama signed into law on Aug. 2 does not address the sustainable growth rate formula that is set to slash doctor pay by 29.5% on Jan. 1, 2012. On top of that, doctors treating Medicare patients could see another cut -- projected at $10 billion to $15 billion annually -- if a special congressional committee fails to agree on a long-term deficit reduction plan that can pass Congress and be signed into law during this session.

Source: Charles Fiegl, Amednews [8/8/11]

Cement Learning

Stop forgetting what you have learned. Keep new knowledge fresh with these practices:

• Review materials you received and your notes immediately after the learning session, such as a workshop. While your memory is fresh, fill in any gaps and make sure that you understand what you wrote.
• Rewrite your notes, organizing them into an outline or a diagram.
• Refresh your memory after a day,  a week, a month, and a quarter. Start by writing what you can recall, and then compare that with your detailed notes.

Source: Adapted from “Keeping Knowledge in Your Short-Term Memory,”  Mind Tools, via Communication Briefings

Query: Gout ICD-9 Code

I have used ICD-9 274.9 (gout, unspecified) and ICD-9 274.0 (gouty arthropathy), and both were rejected by Medicare. What is the correct ICD-9 code for gout?

John Fanelly, DPM, Philadelphia, PA

Response: You are using out-dated codes. You may want to consider subscribing to the APMA Coding Resource Center (apmacodingrc.org). These are your gout coding options:

ICD-9 274.00 - gouty arthropathy, unspecified
ICD-9 274.01 - acute gouty arthropathy
ICD-9 274.02 - chronic gouty arthropathy without mention of tophus (tophi)
ICD-9 274.03 - chronic gouty arthropathy with tophus (tophi)

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: Recalcitrant Wound  (Samuel Rosenwald, DCh)
From: Chris Browning, DPM

I had a similar patient who had fallen from a height and suffered a calcaneal fracture. A local orthopedist performed ORIF and the patient eventually developed osteomyelitis, wound infection, and dehiscence. The orthopedist removed the hardware, and the patient developed an open wound/sinus extending down into the calcaneus. The patient saw another doctor who treated him with HBO, wound care, and VAC. When the patient came to me, he had been walking around for one year with a piece of foul smelling calcaneus exposed in the base of the wound. MRI revealed chronic osteomyelitis. Sed Rate/CRP was negative. I took the patient to the OR and debrided all of the bone out and then took a rotary burr and roughed up all of the area down to healthy bleeding bone. I mixed Wright Medical Osteoset beads but instead of making individual beads, I put the hardening solution in a syringe and squirted it into the calcaneus to fill the void in the bone. I had already added Vancomycin and Tobramycin. I also took a bone culture PRIOR to this. The solution hardened nicely, and I excised the ulcer out and performed flap closure of the skin.  

I left this in place for about six weeks. Commonly seen with these beads, there was moderate serous drainage from the wound, and I applied the VAC.  Much of the bone healed in and on x-ray, the patient's calcium sulfate plug was getting smaller and resorbing. After about six weeks, I went back in, removed the plug, roughed up the bone again, and had an orthopedic colleague harvest fresh iliac crest graft. I then packed it into the defect. The wound and BONE healed rapidly and uneventfully. Get a bone biopsy and/or MRI. There is dead or infected bone in the wound. The calcaneus heals very well under the right conditions.  

Chris Browning, DPM, Temple, TX, chrisbrowning@att.ne

RE: Prescription Data and HIPAA (Eliot Udell, DPM)
From: Michael Brody

A recent Supreme Court decision discusses the issue of data mining by pharmaceutical companies.

Michael Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: 93% Error Rate for Therapeutic Shoes (Jeffrey A. Szczepanski, DPM)
From: Josh White, DPM, CPed

At the risk of sounding self-serving, I encourage DPMs to investigate SafeStep's "WorryFree DME" to ensure compliance with Medicare documentation requirements. While literally thousands of DPMs have received pre-payment audits, not one that I am aware of who uses SafeStep to procure MD documentation has failed. Regardless of whether you order the shoes from SafeStep, save your office staff the burden of repeatedly faxing documents to the certifying MD. SafeStep will do it for you and even archive the signed documents in case Medicare comes knocking and you cannot locate all seven documents they may be looking for. SafeStep will process your first 20 orders for free; after that, it only costs 99 cents per order. Stop faxing and start fitting. If the number of shoes fit each year by DPMs is not increasing, there is something seriously wrong.

Josh White, DPM, CPed, President Founder, SafeStep,  joshwhite@safestep.net

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's???  Email today dri@myfcny.com.

EQUIPMENT FOR SALE - CLASS FOUR LASER

ASSOCIATE POSITIONS – MARYLAND
 
Are you motivated, personable and enjoy working with the elderly? We are offering full or part-time positions in Maryland. Our group, Podiatry Management Services, provides care to the elderly in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your c.v. to drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255

ASSOCIATE POSITION -CENTRAL VALLEY/SOUTHERN CA

Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION - CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. $10,000 advance incentive to help move & immigration and work contract. Reply to dr.cole@shaw.ca

ASSOCIATE POSITIONS - NW INDIANA

RESIDENCY OPPORTUNITY - MASSACHUSETTS

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