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| PM News | |
The Voice of Podiatrists
Serving Over 22,102 Subscribers Daily
October 06, 2022 #7,354  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management https://podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2022- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
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Are you in favor of ABPM's Certificate of Added Qualification (CAQ) in podiatric surgery?
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| PODIATRISTS IN THE NEWS | |
"Don't Self-Diagnose Your Feet" - NY Podiatrist
More than just a chance to relax, pedicures are a great way to take care of your feet—so long as you use your own tools. “Having a personal cuticle remover, exfoliator scrub, nail file, and more can go a long way to reducing the spread of bacteria and fungus,” Jacqueline Sutera, DPM, owner of City Podiatry says. Feet that look good generally feel good, too, so check yours regularly. Healthy nails should be thin and pink or clear in color.
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Dr. Jacqueline Sutera |
If you see a crack in your skin, over-the-counter moisturizers with exfoliants can work wonders to help heal it. Persistent peeling, itching, or yellowing of the skin or nails requires a trip to the doctor. Whatever you do, don’t self-diagnose your feet. “Foot infections can spread quickly and easily,” says Dr. Sutera. “The best thing to do is see a doctor if anything seems amiss.”
Source: Ana Pelayo Connery, Women's Health [10/3/22]
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| PODIATRISTS AND POLITICS | |
MI Podiatrist is Running for 18th District House District
Recent redistricting changes have connected the Farmington area more with Southfield. Republican Wendy Webster Jackson, DPM is running in the November election.
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Dr. Wendy Webster Jackson |
Dr. Jackson specializes in podiatric medicine and previously ran for the city clerk in Southfield.
Source: David Veselenak, Hometownlife.com [10/4/22]
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| ON THE INTERNATIONAL LECTURE CIRCUIT | |
AAPSM Members Speak on Shockwave in Columbia
American Academy of Podiatric Sports Medicine (AAPSM) Members Amol Saxena, DPM (Past-President) and Ludger Gerdesmeyer, MD, PhD (Honorary Member) were the Keynote speakers at the Latin American Society for Shockwave in Medicine meeting September 29-October 1, 2022, in Colombia. Conference organizer, orthopedist Carlos Leal, MD and sports physician Ethy Oziel also spoke. Gerdesmeyer and Saxena recently published on electromagnetic therapy (EMTT) in the journal Electromagnetic Biology and Medicine.
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(L-R) Drs. Ludger Gerdesmeyer, Carlos Leal, Ethy Oziel, and Amol Saxena |
Dr. Saxena was published along with lead author, also an AAPSM Honorary member, Nicola Maffulli, MD, PhD on “The double postero-medial portals endoscopy for posterior ankle impingement syndrome in athletes” in the Journal of Orthopedic Trauma. The two also have a publication accepted on the largest series of tarsal coalition resections (97) in the Journal of Orthopedic Surgery and Research with their former fellows, Ryan Allen, DPM and Filippo Migliorini, MD.
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
RE: Effective AR Management Strategies
There are scores of effective AR management strategies, proven by experts of the medical billing industry, which have helped healthcare organizations to cut through the noise and manage their financial health.
8. Invest in automation tools: A multidimensional support system takes a medical setting a long way. From analyzing big amounts to gathering necessary a timeline of claims, automation has got you covered. Digital transformations and proper infrastructures like these ensure that the AR management is highly- efficient.
Source: Hariharasudan Neelarathinam, Physicians Practice [9/22/22]
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| CODINGLINE CORNER |
Query: Self-Pay Guidelines
When patients do not qualify for routine foot care to be covered by Medicare or commercial insurance, we inform our patients the services are not covered and offer self-pay pricing for the services. Are we required to charge the patients the Medicare or commercial insurance allowed amount for these services? Is the proper way to do this to submit to the insurance with an expected denial modifier so that it shows up on an EOB? Are we allowed to charge at the time of service and not submit to the insurance company with an ABN?
Anne Shaffer, DPM, Gainesville, VA
Response: Routine foot care is statutorily not covered (with a few exceptions: at-risk, pain), hence you can bill your usual and customary fee for that service, not the Medicare fee. You should bill Medicare with the appropriate CPT codes appended with the -GY modifier which tells the computer that this is a non-covered service. The denial will read “not a covered service,” and the patient responsibility will be your fee.
You could bill this with only a nail or callus code without the secondary qualifying at-risk or pain code and the service will be denied as well. But the denial reason will be “not medically necessary”, patient responsibility $0.00. You could not bill the patient with that denial code. Yes, you can collect at the time of service the entire fee. You are not obligated to submit a claim for a non-covered service unless the patient insists. Theoretically, a secondary insurance could pick up the service even if Medicare does not.
No ABN is required for statutorily not covered services. The only twist is if the patient does qualify for routine foot care services but wants to come in much sooner than the 60 day allowance. Then an ABN would be required, because the service is covered… but not in this particular situation.
Tony Poggio, DPM, Alameda, CA
For information on Codingline subscriptions, click here
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| QUERIES (EMR) | |
Query: Athena or Aprima
Does anyone use Athena or Aprima for EMR and what are your reviews? I have searched the past database and did not see these two products reviewed or discussed.
Patty DiCaprio, Mohawk Valley Podiatry, Schenectady, NY
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Brian Lee, DPM, Lance Malusky, DPM
I had a very similar situation many years ago. Don't bother trying to numb the toes. If you're good and efficient, you can do a partial avulsion in literally 5 seconds. I did that and the ingrowns resolved quickly. I saw her again as a late teenager for something else but her toenails were never a problem again. Problem solved.
Brian Lee, DPM, Mt. Vernon, IL
I have treated a few patients this young over the years. The bigger problem is the over-protective parent. The question of hospital management is expense, and many anesthetists may not have the patience to be kind. My office technique involves managing the parents' expectations of painless surgery. To numb the toe, a calm parent, and a less distraught friend is utilized. One person holds the ankle while the other reassures the child that all is well. The physician then uses ethyl chloride spray and a hallux V-block. After a few moments, the ankle holder is shown that the toe is numb by poking the toe with a semi sharp instrument with no response from the child. A slant back may be considered, but recurrence is at risk, considering that this clinical picture suggests a permanent anatomical medial border curvature. Only if both borders show that, would the lateral borders be corrected; if lateral paronychia without curvature is seen, a minor slant back only, with curettage of granulomatous tissue is considered.
The usual surgical approach is with an English anvil nail nipper, and then a #61 mini Beaver Blade, which splits the nail plate to the matrix zone. Remove the offending nail with a small straight hemostat. A culture and sensitivity can be considered. Inspect under the posterior nail groove for any cutaneous debris that might cause a later foreign debris reaction. Standard phenol Q-tips are useless. Instead, a flat toothpick with a wisp of cotton is spin-loaded. 2 X 20 seconds phenol is utilized, rolling the same direction that the cotton was loaded. Dab away any excess phenol before lavage. Dress as usual.
Lance Malusky, DPM, Dayton, OH
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Tom Silver, DPM, Martin M Pressman, DPM
The youngest patient I ever performed a permanent ingrown on was a 6 week old! The pediatrician sent him to me as the nail border was severely abscessed. It was either congenital or acquired, but either way, it is not too difficult to correct this permanently. I recommend having something sweet for the baby to suck on and numb with a 30 gauge needle. Be very quick and since the toe is very small, just take out a very small sliver. It helps to have a ring light with a magnifying lens when you do this too. I have performed ingrown procedures on many children and find that they are easier when they are infants and much more difficult as they become toddlers. Toddlers will fight and scream more and often will need some form of sedation such as Benadryl.
Tom Silver, DPM, Golden Valley, MN
I have years of experience with this issue and I can give you some hard won advice.
1. These are painful and need treatment. The baby does not “grow out of it.”
2. Do a P&A on both sides. This is a problem you do not want to revisit.
3. This can be done in the office; however, it is difficult to do with the baby kicking and crying and will wear both you and the staff out for the day. That said, I have done these in the office but I prefer to take them to the hospital and do them under anesthesia. I position them sideways across the table. I also block the toes with 1cc Marcaine for post-op analgesia.
4. You will need tiny Beaver blades, curettes, and P&A cotton tip applicators. Phenol sticks are too large but you can use the phenol with your own cotton tip applicators. You will need to supply the phenol packs.The hospitals never have the proper equipment and you need to bring in an office kit for them to re-sterilize a few days before the procedure.
5. Don’t be afraid to excise the hypertrophied nail fold at the same time. No sutures are required. I often use a tissue nipper for that. The youngest patient was about 3 months. I have seen younger, but would often do an office slant back until they were older and larger, and then bring them in for surgery.
Martin M Pressman, DPM, Milford , CT
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 1 | |
RE: October is Breast Cancer Awareness Month
From: Elliot Udell, DPM
Twelve months ago, I was diagnosed with breast cancer. Luckily, I caught it early and after surgery radiation and medicines, my medical team is optimistic.
The reason why I am public about my medical history is to make as many people as possible aware that this disease exists in both sexes and we should all be checking ourselves in the appropriate way as advocated by the American Cancer Association. For women, it is an annual mammogram and for men, any sign of lumps or bumps in the breast area warrants an immediate visit to one's primary care physician.
Elliot Udell, DPM, Hicksville, NY
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2 | |
From: Jay Seidel, DPM, Edwin S. Hart III, DPM
I have been using On Time Medical Billing Solutions for the past 3 years. They are responsive, competent, fairly priced, and aggressive with collecting my reimbursements. I highly recommend it.
Jay Seidel, DPM, Deerfield Beach, FL
I have been using Mediclaim, Inc. from Philadelphia with great success. Rates are very good and the owner Mark Liddy is the one to contact. With overhead increasing and no increase in reimbursement, it makes sense to outsource billing these days.
Edwin S. Hart III, DPM, Bethlehem, PA
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 3 | |
RE: American Diabetes Association Launches 3-Year Alliance to Reduce Amputations
From: Leonard A. Levy, DPM, MPH
A three-year effort was launched by the American Diabetes Association called the Amputation Prevention Alliance (APA) designed to decrease the number of diabetes-related amputations in the country — including five partner organizations. They will work to advocate policy changes, increase clinician education about caring for diabetic complications, and improve patients' awareness of warning signs. 2016 data on diabetes-related amputations from the Centers for Disease Control and Prevention (CDC), shows that there were 4.9 lower-extremity amputations per 1,000 diabetic adults in the U.S. More than half of those people who have had a lower-extremity amputation end up having an amputation of the opposite extremity within five years, according to the CDC.
The APA, including its five partners, is a three-year effort to decrease the number of diabetes-related amputations in the country. The partners include diabetic foot care provider Podimetrics, ...
Editor's note: Dr. Levy's extended-length letter can be read here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Who needs heels, anyway? (photo: Talya Crudo) |
Source: Aya Feldman via Virtual Shoe Museum
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MEETINGS & WEBINARS
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $279 (less than $19 per CECH)
podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, PA, RI, SC, SD, UT, VA, VT, WV, and WI
Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY, NC, OK, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
* NY podiatrists whose licenses expire from 3/2/20-8/31/22 may take all credits online
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| CLASSIFIED ADS - ASSOCIATE AND FACULTY POSITIONS, AND FELLOWSHIPS |
ASSOCIATE POSITION - VIRGINIA (NORTHERN)
Immediate opportunity to join a multi-office practice. In search of a well trained, hard working, ethical podiatrist to take this well established full scope practice to the next level. Competitive salary and benefits package. Looking for a long-term relationship. Will wait until summer for the right individual but prefer a start date as soon as possible. Reply to: krpsgold@cox.net.
ASSOCIATE POSITION – WESTERN NORTH CAROLINA
Join a well-established, busy and growing podiatric practice. We are fully integrated with the medical community in a large tertiary teaching hospital. Research opportunities are available. Applicant should be ethical, personable, hardworking, and committed to quality patient care. We are offering a competitive salary with bonus opportunities and a wide range of benefits. Associate position can lead to partnership. All interested candidates should send a resume to JCMOOREDPM@aol.com
ASSOCIATE POSITIONS – LOUISVILLE, KY
National podiatry leader hiring physicians to practice at state-of-the-art facilities in Louisville — with more national locations to come soon. Our physicians receive generous compensation, bonuses, and a path to partnership without the financial risk. Email resume to careers@pacesetter-health.com or apply online at https://pacesetter-health.com/#careers
FOOT & ANKLE SURGEON NEEDED - FT LAUDERDALE
Growing group with immediate open position. Full schedule, good variety of pathology, robust support staff, well equipped office, and many ancillaries. Help train our fellow! BQ/BC ABFAS required. Competitive salary/ benefits. Send CV to podiatrymanda@gmail.com
ASSOCIATE POSITION – BROOKLYN, NY
Podiatrist position available for immediate hire in a multidisciplinary practice for part time in Brooklyn, New York. Flexible hours and potential to progress to full time. Ideal position for recent grads. Send resume to dr.shtarkman@gmail.com or call Dr Shtarkman at 917-363-2702.
ASSOCIATE POSITION - PITTSBURGH, PA AREA
Multi doctor, multi office practice seeks a full time Associate trained in all aspects of podiatry and surgery. We currently have four office locations around the Pittsburgh area. The candidate must be board certified or board eligible and must have a Pennsylvania license or be eligible to obtain one. We offer a competitive salary with a bonus opportunity, a 401K and profit-sharing plan and health insurance. To apply, please forward a CV to: drkmo12@gmail.com
ASSOCIATE POSITION - ST. GEORGE, UT
Immediate Doctor of Podiatric medicine position for a well-trained, highly motivated individual. Location: St. George, Utah. Competitive salary with commission structure. Benefits include: PTO, CME allowance, health and malpractice insurance. Must be confident in working solo in your own office environment. Please email Cover Letter and CV to st.georgefootcare@gmail.com
ASSOCIATE POSITION - CHICAGO SUBURBS
Looking to hire Summer 2023. Thriving podiatry practice in Chicago suburbs looking for an associate to take practice to the next level. Must be highly motivated and have the ability to WOW our patient with your charismatic personality and professionalism. This is an excellent opportunity to work in a state-of-the-art office (which includes MRI) with a team-oriented culture. 3-year surgical residency required. Submit CV to jswalter@hotmail.com
ASSOCIATE POSITION - CALIFORNIA
Come join a team that is changing lower extremity care across California. Bay Area Foot Care has openings for energetic, warm and positive podiatrists in our San Francisco Bay Area Locations. As part of our group, you will work with leading doctors across subspecialties and receive the tools and support necessary to grow your practice. Excellent training, competitive compensation, comprehensive benefits, and a 401k match included. If interested in learning more, submit your CV to DPMcareers@balancehealth.com
IMMEDIATE ASSOCIATE POSITION AVAILABLE – SW FLORIDA (NAPLES/FT MYERS)
Seeking BC/BQ physician for a well-established podiatry practice in beautiful SW Florida. Looking for a motivated and well-rounded candidate who has patient care as priority #1. Multiple hospital affiliations and excellent opportunity for growth. For inquiries please contact footdocswfl@gmail.com
ASSOCIATE POSITION - WISCONSIN
Looking for personable, highly motivated podiatrists in the Wisconsin area. Podiatrists that join our team will benefit from the satisfaction of providing care to residents in Longterm Care Facilities. Above average compensation package plus other benefits. Look forward to adding you to our team!! Inquiries can be sent to info@completepodiatrycare.com
IMMEDIATE ASSOCIATE POSITION - SOUTHWEST, FL
Stat, busy, modern offices. ABFAS BC/BQ, EMR, Dig x-rays, U.S., CT, DME, Base salary + bonus, PTO, 401K, free health ins. 1 ACFAS fellowship position also DrLam@NaplesPodiatrist.com
ASSOCIATE POSITION – BEVERLY HILLS, CALIFORNIA
SIGNING Bonus. We are looking for a podiatrist that provides service to our in-office patients, skilled nursing home patients, wound care patients and our affiliated hospitals. Required: Completion of a 3-year residency program • Current holder of a state podiatry license • Board certification/qualification is highly preferred • Looking for well trained, well rounded and personable candidate to plug into our growing group of 5 Podiatrists and 4 locations. Competitive 6 figure base with lucrative bonus structure. Full benefits including 401K and match. Email resumes directly to victorian@footnankledoc.com
ASSOCIATE POSITION - PENNSYLVANIA
Join a well-established, busy and growing private podiatry practice. Multiple locations in the Pittsburgh area. Applicants should be hard-working and committed to quality patient care. We are offering a competitive salary with bonus opportunities. Associate position can lead to partnership. All interested candidate should email résumé to Academyofpodiatryfootdocs@gmail.com
ASSOCIATE POSITION - CENTRAL ILLINOIS
Seeking podiatrist for established and successful Central Illinois practice. Come join a team where you will be respected and supported. Base salary plus incentives and competitive benefits. Please send a letter of interest and/or resume to sara@cortesefootandankle.com or call Sara @ 309-452-3000 for further information.
POSITIONS AVAILABLE - MASSACHUSETTS, MISSOURI, PENNSYLVANIA and BUFFALO, NY
Looking for reliable and ethical podiatrists to service Nursing Homes and Skilled Nursing Facilities throughout Massachusetts, Missouri, Pennsylvania and the Buffalo, NY region. Send inquiries and CV to: phasetwopodiatry@gmail.com
ASSOCIATE POSITION - PHOENIX, AZ
Well established, large group podiatry practice has an immediate opportunity for an associate as well as July 2023. Must have completed a 3 year surgical residency, have Board Qualification, AZ License and bilingual Spanish is a +. We have several office locations in the Greater Phoenix area ready for someone to make the most of. We have a good balance of office and surgical practice. Base pay with bonus package, medical, CME, malpractice, and 401K. Looking to fill immediately as well as fill July position. Please submit resumes to: podiatryaz@gmail.com
ASSOCIATE POSITION - NYC (IMMEDIATE)
Multi-location boutique office in Manhattan is hiring a surgically trained practitioner to join our sports-medicine practice. If personable, motivated and driven to succeed, we would be delighted to have you join. We offer a strong compensation package: associate average $250K+/year, health benefits + retirement pension. https://tinyurl.com/ApplyTHFP
ASSOCIATE POSITION - HUDSON VALLEY, NY
Associate needed for a multi-specialty group in the Hudson Valley, NY (1 hour north of Manhattan). All aspects of in office and surgical podiatric care. Competitive salary with bonus structure and benefits. Please send resumes to CKYROU@NORTHERNMED.COM.
WOUND CARE FELLOWSHIP - MICHIGAN
Beaumont Hospital 12-month Diabetic Limb-Salvage, wound care and reconstruction fellowship beginning July 1st, 2022. This Fellowship is designed to enhance and refine the skills of residency-trained Podiatric Surgeons. Heavy focus on wound care, research, and diabetic limb salvage surgery. Full-benefits and competitive salary. Please email your CV to Randy.Semma@beaumont.org
PM NEWS CLASSIFIED ADS REACH OVER 22,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE – CENTRAL PA
Turn-key 30-year-old established practice with loyal, compliant, educated patient base. High surgical volume. Located in the pearl of central PA with the cultural advantages of a university town and great school system. Grossing seven figures prior to Covid. Retiring physician willing to finance and help. nvafc@md-officesolutions.com. 814-231-0130
PRACTICE FOR SALE - CENTRAL GA
Outstanding opportunity. Busy practice with fully licensed and accredited sx ctr for sale. High volume patient flow. Fully equipped and staff practice and sx center. Owner desires to retire. Opportunity to expand and grow business. Contact MCrosby518@gmail.com
PRACTICE FOR SALE - NORTHERN IL
Located approximately 50 miles west of Chicago this practice has high volume and strong collections. Wide array of services including surgery. The office is fully equipped and staffed. Dedicated procedure room. In medical corridor close to hospital and surgical center. Strong payor mix with no public aid or nursing homes. Currently open 3.5 days per week. Contact: MCrosby518@gmail.com
PRACTICE LOCATION FOR SALE – ATASCOCITA, TX
Recently remodeled, well-established, turn-key podiatry practice for sale in Atascocita, TX (northeast suburb of Houston). Fully stocked with four exam rooms, exam chairs, instruments, digital x-ray equipment, autoclave, computers, and phones. Contact Rebeccah at 281-361-7400 or rburgers.tcfa@gmail.com.
PRACTICE FOR SALE - GA/SOUTHWEST
Well-established 26 year old practice for sale located in Southwest Georgia. A broad based practice with special interest in diabetic limb salvage. Excellent growth potential in all aspects. Office is well equipped with three treatment rooms. Will assist with transition and obtaining surgical privileges. Price is fair market value. Contact: MCrosby518@gmail.com.
PM NEWS CLASSIFIED ADS REACH OVER 22,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 22,000 subscribers. For details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
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