The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 20, 2008 #3,328 Editor-Barry Block, DPM, JD

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Williams Elected President Of AAPSM

At the American Academy of Podiatric Sports Medicine (AAPSM) Annual Meeting held this past July in Honolulu, Hawaii, Bruce E. Williams, DPM, a sports medicine podiatrist in private practice in Merrillville, Indiana was elected President.

Dr. Bruce E. Williams

Dr. Williams received his Doctor of Podiatric Medicine degree from the Scholl College of Podiatric Medicine. In addition to being a Fellow and President of the AAPSM, Dr. Williams is also a Fellow of the American College of Foot and Ankle Surgeons (ACFAS) and the American Board of Podiatric Surgeons (ABPS).

Also elected were: President-Elect- David M. Davidson, DPM, Amherst, New York, Vice President - Karen Langone, DPM, Southampton, New York, Secretary Treasurer- James Yakel, DPM, Longmont, Colorado and newly elected Director, Robert Conenello, DPM, Orangeburg, New York. Matthew Werd, DPM, Lakeland, Florida serves as Immediate Past President. Rita J. Yates, of Walkersville, Maryland, serves as AAPSM Executive Director.

PA Podiatrist Uses Internet Communications to Prevent Cardiovascular Disease

Anthony Kidawa knows how important it is for patients to communicate with their doctors, especially when it comes to their cardiovascular health. Kidawa, a podiatrist for more than 35 years, specializes in peripheral vascular health, and has seen the ravages of poor cardiovascular health on the lower extremities first-hand. That’s why he decided to participate in a study at Temple University to see whether regular, Internet-based communications with doctors and healthcare professionals could help lower the risk of cardiovascular disease in high-risk, yet healthy individuals.

Dr. Anthony Kidawa

Kidawa received a device to measure blood pressure and a pedometer to measure daily steps, along with advice on exercising and its benefits in preventing heart disease. During the study, he regularly reported his blood pressure, weight and pedometer data to cardiologists, and received feedback and educational information via the Internet. “I’ve lost 10 pounds so far, and I’ve seen a reduction in my blood pressure since the beginning of the study,” Kidawa said.

Temple researchers found that adding the Internet reporting system to traditional office visits allowed participants to communicate more frequently with their healthcare providers, and as a result, they were able to lower their risk of heart disease by improving blood pressure, blood lipid levels and cardiovascular disease risk score.

New Stark Rules Unveiled

CMS has made some changes to the Stark self-referral ban that will stick this time, and a few could have a significant effect on hospital-physician relationships. They appeared in the final inpatient prospective payment system (IPPS) regulation unveiled July 31 and due for publication in the Aug. 19 Federal Register.

The industry will soon have to navigate new Stark rules on percentage-based compensation, per-click arrangements and the "stand-in-the-shoes" analysis. And it's time to sunset "under arrangements" with physicians because CMS finalized its revised definition of entities that provide designated health services (DHS) under Stark. But CMS also cleared a path for returning to Stark compliance over unsigned physician contracts, and clarified how providers can end the "period of disallowance," when a Stark violation renders Medicare claims unpayable.

The Stark self-referral law bans Medicare payments to entities providing DHS if they were provided to patients referred by physicians with an ownership, investment or compensation relationship with the DHS entity.

Source: Report on Medicare Compliance [8/11/08]

What to Say When You Draw A Blank

You know the patient approaching you - but the name escapes you. Don't worry; that happens to everyone now and again. You needn't be embarrassed and you certainly should not pretend. Simply say something like this:

• "I'm sorry; I have forgotten your name."
• "Please help me out. I've gone blank."

Tip: If you suspect that someone has forgotten your name, help that person out. Say "Chris, Pat Smith; how are you?"

Source: Adapted from Power Phrases: The Perfect Words to Say It Right and Get the Results You Want by Meryl Runion

Query: Hypaque Injections

Can anyone provide more information on using hypaque to inject tendon sheaths for heel and ankle complaints and evaluate them on x-rays?

Isaac Tabari, DPM Brooklyn, NY

Query: Accessing Old Issues of PM News

Is there a way to access old issues of PM News? I accidentally erased one from a couple of weeks ago that I'd like to access.

Albert. Bravo, DPM, Great Barrington MA

Editor's Response: Old issues of PM News are available on our website, www.podiatrym.com Simply go to the PM News Section on the left side of the page and click on “current issue.” From here, you can click on "previous issue". When you do this, you’ll notice that the date of that issue will appear in the URL address bar of your browser. To find a specific date, simply replace the date shown with the date you are looking for.

Alternatively, you can use our search engine to locate letters on specific topics or from specific note posters.

Query: Claim Verification Reports

Our office prints out a paper copy of an electronic claim verification report daily. If an insurance company denies a claim based on “proof of timely submission,” we search through these reports to locate the electronic claim verification report that proves that we did indeed send the claim out on a timely basis.

This procedure has become superfluous, and has generated a voluminous amount of paper work that we store away. I am considering terminating this protocol thus making the burdensome task of storing these records unnecessary. Is this procedure followed at most offices? Is it a legal requirement to keep paper copies of these reports?

Joe Boylan, DPM, Ridgefield, NJ

Response: Newer technology allows for several options:

- Scanning your paper to disk for storage
- Your software company allowing the reports to be archived automatically
- Your clearinghouse allowing the reports to be archived.

Any of the above options still allow for a search option when researching claims.

Since the software I use is entirely online, the only time I print a report is when there is a problematic claim. I make notations on the report of the correction/resolution, then scan the document to a 'resolved claims submission' file.

I run my billing office about 90% paperless.

Karen Hurley, CMM, CPC-I, Waldorf, MD

Codingline subscription information can be found here

RE: Studies Establishing Medical Necessity of Custom—Made Orthotics ( David S. Wolf, DPM)
From: Bret Ribotsky, DPM, Mark Light, DPM

ACFAOM has created a "White Paper" on Prescription Custom Foot Orthoses - Practice Guidelines. This paper was developed and written by nine luminary DPM's and is available by clicking here. I have used this document many times with insurance companies and in the courtroom defending the value of orthoses. Every DPM should have a copy of this document in their files.

Bret Ribotsky, DPM, Boca Raton, FL, Ribotsky@Doctorbret.com

Here are some articles that address the medical necessity of orthotics. These were studies done by MD's:

Mary Powell, Michael Seid, and Ilona S. Szer, “Efficacy of Custom Foot Orthotics in Improving Pain and Functional Status in Children with Juvenile Idiopathic Arthritis: A Randomized Trial”, J Rheumatol 2005;32:943–50.

E.E. Bleck, M.D. and Uldis J. Berzins, B.A., “Conservative management of Pes Valgus with Plantar Flexed Talus, Flexible, Clinical Orthopedics and Related Research, No. 122, Jan-Feb, 1977.

R. Luke Bordelon, M.D., “Correction of Hypermobile Flatfoot in Children by Molded Insert”, Foot & Ankle, Vol.1, No. 3, 1980.

Mark Light, DPM, Marietta, GA, light@eastcobbfoot.com

RE: History and Physical Course (Thomas Brooks, DPM)
From: R. Alex Dellinger, DPM

We are offering an H&P course at the fall meeting of the Arkansas Podiatric Medical Association meeting Oct. 10-11-12, 2008. It will be an intensive course. Please e-mail me for more information.

R. Alex Dellinger, DPM, Little Rock, AR, raddpm@yahoo.com

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