The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

October 03, 2007 #3,056 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2007- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Steinberg Performs First Live Podiatric Surgical Case Transmitted to Conference Audience

On Friday, September 28, 2007, John S. Steinberg, DPM, performed what is believed to be the first live surgical case by a podiatric surgeon transmitted to a live medical conference audience. The live surgical case took place during one of four live cases at Georgetown University Hospital’s ORs and transmitted to an audience of nearly 1,000 attendees at Georgetown University Hospital’s Conference on the Team Approach to Diabetic Limb Salvage in Washington, DC. Dr. Steinberg is co-director of the Center for Wound Healing and co-director of the limb salvage team at Georgetown University Hospital.

Dr. John Steinberg operates live before Georgetown audience

The interactive live connection allowed telecast of the operative cases and featured real-time interactive questions about the cases which were directed back to the OR from the panel and moderator at the conference hotel. The two cases involved percutaneous tendo-Achilles lengthening, bio-engineered alternative tissue applications, hydrosurgical debridement, and specialized negative pressure dressing application techniques.

Participating in the live case session panel were Christopher E. Attinger, MD; Vickie R. Driver, DPM, MS; William J. Ennis, DO, MBA; Michael J. Mueller, PT, PhD. The Georgetown live cases were captured on video and will be made available, along with selected educational sessions, as streaming video on the web at www.DLSConference.com

Two Barry Students Receive PICA Scholarships

Val Haddon from Shelley, ID, and Ngozi Ezeude from Houston, TX, have been selected by Barry’s full-time podiatric clinical faculty to receive $2,500 scholarships from the Podiatry Insurance Company of America (PICA) based upon their excellence in third-year clinical rotations this past academic year.

Val Haddon

Ezeude

PICA has also committed to sponsoring the annual white coat ceremony at Barry University’s School of Podiatric Medicine for the next five years. A tradition at Barry since 1996, the white coat ceremony is a right of passage which marks a student’s transition from classroom to clinical training. During the ceremony each student is presented with a white coat, the recognized attire of the medical profession for thousands of years.

WI Podiatrist Finds Second Career as a Teacher

The biology students at Milwaukee's High School of the Arts have a real expert at the head of the classroom. A local foot doctor has decided to try his hand at teaching. Dr. Paul Zerovec is going through an alternative teacher certification program, while still running his podiatry practice on the East side.

Dr. Paul Zerovec

He said he always enjoyed giving lectures and teaching in nursing homes, so he thought he would give high school teaching a try. So far, so good. He's been in the classroom for three weeks, and survived the high schoolers.

Source: WITI-TV, Milwaukee [9/27/07]

Query: Measuring Device For Pad Placement

Is there a measuring device to assure the appropriate placement of a metatarsal pad or metatarsal bar on an orthotic. I have found that eyeballing the foot and guessing at the correct placement has usually put the pad more proximal than it should be.

Frank DiPalma, DPM, Athens GA

Query: Billing Recurring Plantar Fasciitis Treatment

If a Medicare patient sees you for plantar fasciitis, and gets better after treatment, and then three months later sees you again for recurring symptoms of plantar fasciitis, and you bill an E/M code and an injection code, is that acceptable with Medicare in North Carolina?

Melinda Hefti, Concord, NC

Response: The time between injections and/or response to treatment does not determine when you can bill an E/M code in addition to an injection code. Medical necessity and proper documentation determines whether you can do so.

If it was 1) medically necessary to perform an evaluation and management service in addition to the injection, and 2) the chart documents both the necessity and the required E/M components (history, physical and/or decision making), an E/M service billing could be performed. If you do bill for both the E/M service and injection, don't forget to append a modifier "25" to the E/M code.

CMS has provided a MLN Matters explaining when you can bill for an E/M service in addition to a procedure. See

http://www.cms.hhs.gov/MLNMattersArticles/downloads/mm5025.pdf

Mark Schilansky, DPM, Catskill, NY

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

RE: Mixed Fungal Infections (Greg Caringi, DPM)
From: Steven J. Berlin, DPM, Simon Young, DPM

Mixed fungal infections of toenails are very common and particularly more common in patients over 45 years of age. Aspergillus Niger is the most common non-dermatic fungal infection on the foot and is best treated with Sporanox. Lamisil is primarily a dermatophytic drug and has not been shown to be effective.

Steven J. Berlin, DPM, Baltimore, MD, drstevenberlin@yahoo.com

The literature is quite clear that 90% of pathogens are dermatophytes. On the other hand, I find clinically, a shift to non-dermatophytic molds as patients are older (in my experience with fungal cultures). I feel that younger patients are more likely infected with dermatophytes and older have a higher percentage of non-dermatophytic molds.

I am sure I’ll be chastised for poor specimen harvesting, but I’m sure I did it as prescribed. I don't know if there are studies showing age-related nail cultures of the feet e.g., 30-40 year olds, 40-50 year olds, etc.

Simon Young, DPM, New York, NY simonyoung@juno.com

Arthroereisis vs. Arthrodesis (Ivar E. Roth DPM, MPH)
From: Lloyd S. Smith, DPM

Dr. Roth is unfortunately wrong. There is no code for arthroereisis. APMA has tried for years to obtain a code and has been unable to do so. CPT now clearly states to only bill a code if it exactly fits what is being done. Otherwise, the unlisted code is correct. It may make us all mad but those are the CPT rules.

Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

PRACTICE FOR SALE-BEAUTIFUL SOUTHERN COASTAL MAINE

Minimal managed care in well established, very profitable office. Turn-key operation. Contact Podiatrist1111@yahoo.com

ASSOCIATE POSITION - NORTHWEST PENNSYLVANIA

Multi-specialty group is looking to add another Podiatric Surgeon or General Podiatrist to our well-established group. Office locations in northwestern Pennsylvania. Unlimited opportunities exist for the right Associate, wound care experience is a plus. Please forward your CV to adminsec@ips-mso.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

ASSOCIATE POSITION – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

ASSOCIATE POSITION – CENTRAL FLORIDA, ORLANDO AREA

Exceptional opportunity for qualified candidates. Associate position available in a rapid growing, well established multi-office practice. Applicant must be bilingual in English and Spanish, well trained (PSR-24 or more). Compensation includes excellent salary plus incentives and benefits. Please e-Mail CV, letters of reference to CF_resume@hotmail.com

PODIATRIST WANTED – RIVERHEAD, NY

Podiatrist needed in Riverhead, NY for an Article 28 Diagnostic and Treatment Facility with unlimited growth potential. Multidisciplinary site with much cross referral. Great opportunity. Call 631-981-1333. lakechiropllc@optonline.net

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com -- www.homephysicians.com

WEEKLY SPECIAL - One week of ads (5x) for only $85

PM Classified Ads Reach over 9,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 9,000 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.