The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

August 17, 2011 #4,235 Publisher-Barry Block, DPM, JD

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FL Podiatrist Selected as Physician Advisor to Laser Company

Dr. Beth S. Pearce of Orthopaedic Associates of St. Augustine has recently been selected as one of three physician advisors selected to guide a highly respected medical laser company. She will be working to advise them on both their new and established applications for the podiatric medical arena. She brings her 27 years of experience in podiatric medicine and surgery and the treatment of mycosis (fungal infections) in the skin and nails to the company. The new laser will enhance healing and improve outcomes for many diabetic foot wounds. 

Dr. Beth Pearce

Pearce is in her third-term as a governor-appointed member, and present chair, of the Florida Board of Podiatric Medicine. She also is chair of the Probable Cause Panel that identifies misconduct in the field of podiatric medicine and surgery. Pearce is board-certified in Podiatric Orthopedics and Primary Medicine. She specializes in corrective foot surgery, heel pain, diabetic foot and wound care.

Source: St. Augustine Record [8/14/11]

CA Podiatrist Joins Biggs-Gridley Memorial Hospital

Podiatrist Dr. Sean Stoddard has joined the medical staff of Biggs-Gridley Memorial Hospital as a surgeon who specializes in reconstructive foot and ankle procedures and ankle joint replacements.

Dr. Sean Stoddard (Photo: Lisa Van De Hey)

Dr. Stoddard has been a surgeon for 21 years and moved to Chico just six months ago from New Jersey. Growing up in New York, he graduated in 1989 from the New York College of Podiatric Medicine, serving his medical residency in New York. He practiced with a Veterans Hospital in New York for six years and after that was a part of a Southern California Orthopedic group in New Jersey before moving to Chico.

Source: Lisa Van De Hey, Gridley Herald [8/15/11]

AAPPM New Practitioner & Summer Boot Camp Workshop Another Success

The American Academy of Podiatric Practice Management (AAPPM) Summer Conference at the Airport Marriott Hotel in Pittsburgh, PA was another shining success as the AAPPM continues to celebrate its 50th anniversary of providing practice management education to the podiatric profession. This conference is aimed at providing all the practical practice management basics for new doctors; including students, residents, and doctors new to practices, and for doctors who have been practicing much longer. 

Dr. Hal Ornstein

Nearly 150 podiatric physicians and exhibiting companies were in attendance for the 4-day conference this past weekend. Hal Ornstein, DPM, AAPPM Chairman, stated, “This conference is always a terrific opportunity to take AAPPM practice management basic training tools to the membership and give them winning practice management strategies to enhance the doctors' patient care and build doctor practices through expert power pearls lectures, hands-on workshops, and roundtable discussions in all aspects of podiatric practice management.”

Study Guides Use of Docs as Surgical Assistants

A lengthy study from the American College of Surgeons and 20 other surgical specialty organizations provides new guidance on whether an operation may call for the use of a physician as an assistant during surgery. The 176-page Physicians as Assistants at Surgery Report  was last published four years ago and now accounts for 371 new Current Procedural Terminology, or CPT, codes. Organizations that participated in its publication—including the American Society of Plastic Surgeons, the Congress of Neurological Surgeons, and the Society of Thoracic Surgeons—reviewed codes applicable to their respective specialty in the surgery section of the American Medical Association's CPT 2010 to determine the need of a physician as an assistant.

“It may be necessary to utilize nonphysicians as first assistants,” the guide noted. “Surgeon's Assistants, or physician's assistants with additional surgical training should meet national standards and be credentialed by the appropriate local authority,” the guide noted.

Source: Jessica Zigmond, Modern Physician [8/15/11]

Set Simple Rules to Guide Staff

Make it easy for your staff to do the right things. Instead of burying them with a detailed policy manual and complex rules, provide guiding principles that are easy to remember.  The largest U.S. steel manufacturer, Nucor, leads its staff with just five rules:
1. Know the job.
2. Ask questions and experiment.
3. Share what you learn.
4. Do what it takes to be sure something goes wrong only once.
5. Let us know how we can help.

Source: Adapted from “Friday Story: Keeping It Simple at Nucor,” Wally Bock, Wally Bock’s Three Star Leadership Blog via Communication Briefings

Query: Doughnut Tourniquet

I am looking for a “doughnut tourniquet.” I saw them at a seminar and have not been able to find them since. They are reusable and autoclavable. If you know how or where to order this, I would appreciate it.

Scott Shields, DPM, Enid, OK

Query: CPT 17000 with Modifier?

When billing CPT 17000 (destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], premalignant lesions (e.g., actinic keratoses); first lesion) do I need to designate location with an "RT" or "LT" modifier?

I billed AARP Medicare Complete
CPT 99213-25
CPT 17000-RT

AARP is denying the CPT 17000 code stating that "the wrong modifier was used." Is this correct?

Joseph Schoppe, DPM, Stuart, FL

Response: Actually, in this case, CPT 17000 does not take a modifier. CPT describes the code as "first lesion" without a need for an anatomic location distinction.

NOTE: It was, however, appropriate to apply a "-25" modifier to the E/M service code.

Tony Poggio, DPM, Alameda, CA

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

RE: ESWT & NSAIDs   (Paul Kesselman, DPM)
From: Robert Scott Steinberg, DPM

I have been certified to perform "real" high energy ESWT ("real" ESWT) for some 14 years. Those study "suggestions" are NOT suggestions. Have your patient ice her knee and convince her that having some knee pain to allow her to benefit from the full effect of high-energy ESWT is worth it.

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com

Re: Difficulties Implementing EHR (Joe Borden, DPM)
From: Richard A. Simmons, DPM
 
Dr. Borden is concerned about complicated, hard-to-use EHR software that is affecting patient flow. The computer proficiency of the doctor and the staff are key issues here. If the office is attempting to go from all paper to EHR, that is the most difficult and will be the most time-consuming. If the office is transitioning from EMR to EHR, then the transition most likely is seamless. Essentially what happens for all of us is a general slowdown as we learn the limitations of our programs and tweak the programs for our specific practices.

Once learned, the program will be invaluable to you, so be patient. To maintain patient flow, you may need to implement the program initially with every other patient, but input those other patients’ charting later. Naturally, if you have a lot of routine care patients in your practice, these repetitious notes can be handled quickly with the EHR. Inputting the data for new patients is very time-consuming, but can be less labor intense for your office if your program has a patient portal. Unless your objective is to collect $14,000 this year, there is no reason to rush.

My office has made a relatively smooth transition from Medinotes EMR to Practice Fusion.

Richard A. Simmons, DPM Rockledge, FL, RASDPM32955@gmail.com

RE: Legality of Maximalist Running Shoes (Robert Bijak, DPM)
From: Mel Cheskin, MBS, CPed
 
The International Amateur Athletic Association (IAAF) has strict rules and regulations as to the types of footwear allowed in Olympic and international track competition. These rules cover different events and specify thickness of sole, number of spikes allowed, and prohibit mechanical devices, such as springs and devices that could be classified as 'assisting the athlete'.
 
Outside of international competition, such as road races (i.e.,The Boston Marathon), a rules committee, based on IAAF standards, has the final word on equipment (including shoes) that would be considered to be artificially assisting the athlete. Several years ago, runners wearing Spira (metal spring) shoes were allowed to compete but were disqualified from winning the event.
 
It is indeed an interesting era in flat-soled running shoe history - with maximalist brands such as Z-Coil, Spira, and Hoka offering over-engineered assisted cushioning and minimalist brands such as Vibram, ECCO, and Vivo Barefoot stressing minimal support and cushioning.  Nike has both - Shox and Nike Free.
 
Mel Cheskin, MBS, CPed, Boca Raton, FL, Melcheskin@aol.com

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