The Voice of Podiatrists

September 10, 2006 #2,685 Editor-Barry Block, DPM, JD

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PA Podiatrist Hired at Healthcare Firm

Dr. Lorraine Bohanske Possanza

Sunstein Murphy & Associates P.C. in West Chester Pa., has announced the hiring of Lorraine Bohanske Possanza as an associate. Prior to joining the company, Possanza practiced podiatric medicine and foot surgery before entering the practice of law by initially defending physicians and hospitals in the area of professional liability. She is admitted to practice in Pennsylvania and is a member of the American Health Lawyers Association, the Pennsylvania Bar Association, the American Podiatric Medical Association, and the Pennsylvania Podiatric Medical Association. Sunstein Murphy & Associates focuses on health law and small-business matters for clients in Pennsylvania and Delaware.

OH Podiatrist Promoted to VP of CME at SBi

Dr. Nicholas M. Pachuda has been promoted from Director, Continuing Medical Education, to Vice President, Continuing Medical Education for Source: Small Bone Innovations, Inc (SBi). He joined the Company in June 2005. Dr. Pachuda is responsible for developing, coordinating and executing global surgeon and education training for all SBi products and technologies.

Prior to joining SBi, Dr. Pachuda was a Small Joint Product Manager for Arthrex, Inc., a company dedicated to the development of innovative arthroscopy products for Sports Medicine. Before Arthrex, Dr. Pachuda owned and managed a private foot and ankle surgical practice that was among the top income grossing private practices in the U.S. Dr. Pachuda was also Board Certified in foot, rearfoot and ankle reconstructive surgery, as well as Podiatric Orthopedics.

Source: Source: Small Bone Innovations, Inc

AAPSM Elects New Officers

The American Academy of Podiatric Sports Medicine (AAPSM) has announced that Timothy G. Dutra, DPM, of San Leandro, CA has been elected President. Dr. Dutra serves as Assistant Clinical Professor at California School of Podiatric Medicine at Samuel Merritt College. Dr. Dutra is also on the sports medicine faculty at California State University East Bay in Hayward, California and serves on the sports medicine staff in the Department of Intercollegiate Athletics at the University of California, Berkeley, CA.

Dr. Timothy Dutra

Elected along with Dutra were:

President-Elect - Matthew B. Werd, DPM, Lakeland, FL;
Vice President - Bruce E. Williams, DPM, Merrillville. IN
Secretary/Treasurer – David M. Davidson, DPM, Amherst, NY
Director - Marque Allen, DPM, San Antonio, TX
Executive Director- Rita J. Yates, Walkersville, MD

Query: Billing Services

I am considering using a billing service. I am finding it difficult to keep up with the software changes, staff necessary for billing, and fees. What should I look for in a billing company? How much should I expect to pay? Are there hidden fees to watch for, and what companies do you recommend that specialize in podiatry?

Jay Newman, DPM, Delray Beach, FL, Dctrfoot46@hotmail.com

Query: Billing for Seeing Patients on Holidays

In the past I did not have much luck getting reimbursed with CPT 99054 (services requested on Sundays and holidays in addition to basic service) which was deleted for 2006.

What is the current correct procedure code to use when seeing a patient on a holiday?

Brennan Reed, DPM, Quincy, IL

Response: The new code for 2006 is CPT 99050 which states:

"Services provided in the office during times other than regularly scheduled office hours or days when the office is normally closed (eg, holidays, Saturday or Sunday), in addition to the basic service."

In terms of getting paid, Medicare won't under any circumstance (it’s considered a bundled service). However, for other payers, if you see a patient in the office on a holiday preventing an emergency department visit for a patient (who would have been unable to wait to have the problem addressed until after the holiday), I'd suggest appealing the denial with the notes from the encounter and the rationale that it prevented the payer from needing to pay for a much more expensive ED visit to address the patient's urgent concern. I suspect that some payers will consider paying for this service when appealed on a case-by-case basis if the documentation supports the uniqueness of the encounter, and the rationale of attempting to avoid the patient needing to receive care in a more expensive setting.

Joan Gilhooly, MBA, CPC, Deer Park, IL

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

RE: OH Podiatrist Charged With Practicing "Medicine and Surgery" During Fellowship
From: Kyle Hoogendoorn, DPM

Let’s have all the facts on the table not just what channel 10 reports. As we all know during residency and fellowships podiatric physicians are ALLOWED and EXPECTED to practice outside their scope, but within the scope of their attending physicians.

In my case, Dr. Griffin M.D. and Dr. Leak M.D. were my supervising physicians. I was directed to perform these injections under their supervision and prescribed medications for non-podiatric issues under their directions while in my fellowship ONLY. The charges are from 2000 to 2001 ONLY. I was the first podiatrist to be accepted into the program. While in the program from 2000 to 2001, I managed to get it approved by CPME. Prior to that, the fellowship was ACCME/ACGME approved and had been since 1998.

CPME approval is NOT a criteria for participation of a podiatrist and in no way discredits the program. This is another instance of the Ohio Medical Board and general community not understanding the educational process of the podiatrist. Physicians and lay people need to be informed of the amount and scope of training of our profession.

Kyle Hoogendoorn, DPM, kyle_dpm@yahoo.com

RE: Recurring Blisters Sub Met Heads (Steven Block, DPM)
From: Elliot Udell, DPM

What you need to determine is if there excess pressure during gait in the areas where the patient is developing the blisters. This might help you differentiate between a biomechanical problem as a cause of the symptoms or a medical problem causing blistering. The least expensive approach is to order a product called "Pressure Stat." I use this in my practice. It is a simple and inexpensive device for determining excessive pressure patterns during gait. If the areas in question show signs of excessive pressure on the grid, then it might be prudent to try a different biomechanical approach and new types of orthotics or shoes. There are other more expensive products on the market but the above will serve the needs of your patient very well.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Best Mixture For Spider Veins? (Barry Kaye, DPM)
From: Eugene A. Batelli, DPM

I use Polidocanol 1% (polyoxyl lauryl ether) with excellent results. The compound is safe and relatively painless. I get the drug from Miller's of Wyckoff (Wickoff, NJ phone 888-891-3334) and they offer a few different concentrations. I have used 24% saline in the past, and yeah, the patient wasn't too happy. It is a lot more painful and higher ulceration risk. Remember to use appropriate compression afterwards and the Polidocanol works well. I use loupes for smaller vessels as well.

Eugene A. Batelli, DPM, Naples, FL, ebatelli2001@yahoo.com

ASSOCIATE POSITION-INDEPENDENT CONTRACTOR – FLORIDA

Florida License / Medicare and Medicaid numbers in effect and active. High income potential for hard working, ethical and honest DPM great for semi-retired. Transportation a must. FAX CV or Resume to 1-727-785-4697.

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

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

PRACTICE FOR SALE – SOUTHERN INDIANA

Established, respected solo podiatry practice immediately available in scenic southern Indiana. Fully equipped attractive building conveniently located on an active corner with great staff, loyal patients and excellent referral base. Includes relationships with local assisted living and nursing homes. Practice and building available for $200,000. Serious inquiries preferred e-mail to: dhall@cmbuck.com

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

ASSOCIATE POSITION - AUSTIN TX MOBILE PRACTICE

Full or part-time; Texas license. Fine working conditions with excellent support staff and pay. Mobile podiatry clinic and House calls. http://www.footmobile.com Fax CV 210.495.6484

ASSOCIATE POSITON - 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

ASSOCIATE POSITION – NEW ENGLAND

Opportunity in growing New England practice. Well established and respected practice with large office and surgicenter, latest technology, great staff, loyal patients and solid referral base. Close proximity to hospitals, full scope practice. Opportunity for partnership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and contact info to: footdoc@usa.net

DOCTOR’S OFFICE LARGE ROOM FOR RENT NY (FLATIRON) $2000

Medical office space available to share in a great building in the Flatiron District of NYC. Amenities include: 24-hour doorman and elevator access. Room is large, recently renovated, has a sink with working plumbing, central air (CAC), and audio with volume control. Space is also available at the reception bay. Rent- $2000/month if full-time; less if part-time. All utilities except phone included. Dr. Christopher Anselmi 212-475-8104 anselmic@hss.edu

PRACTICE FOR SALE – SOUTH FLORIDA

Miami-Dade and SW Ft. Lauderdale, well established surgical practice for sale. This one has everything. Surgery, Orthopedics, Pediatrics, Trauma, ER, General Podiatry. Participates in all local and national managed care plans. $850,000 but will discount depending on amount up front. Mature, serious inquires with business experience preferred. Email response to podfootdocs@aol.com

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