The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

October 16, 2008 #3,375 Editor-Barry Block, DPM, JD

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Lightweight Shoes Pose Threat to Athletes: CA Podiatrist

Football players put on bulletproof helmets with air bladders to protect their heads from concussions. They wear lightweight, high-performance shoulder pads to shield their upper bodies during impact. They fasten custom braces around the knees to keep their gentle joints from being twisted and tweaked out of normal position. They've got it all covered: heads, shoulders, knees and … toes? What about the feet?

Dr. Jeff DeSantis

"We're seeing a lot of high-profile players with foot injuries, and the modern shoe is a big component in this problem," said podiatrist Jeff DeSantis, director of the Orange-based practice, Cambridge Foot and Ankle Associates. "Players intuitively seek out the lighter shoe for comfort and speed without thinking about how vulnerable a less-structured, less-rigid shoe leaves them to injury."

Source: Orange County Register [10/14/2008]

Barry Hosts Podiatric Fixation Workshop

On September 25, 2008, the Barry University School of Podiatric Medicine hosted a fixation in-service with Synthes USA, who develop and produce instruments, implants, and biomaterials for the surgical correction of the skeleton and soft tissues of the lower limb. This hands-on learning experience provided a firsthand opportunity for third-year students to work with cutting-edge fixation hardware at fully-loaded individual workstations.

Jordan Tacktill and JD Sills-Powell, Class of 2010

According to Thomas Merrill, DPM, professor of surgery for the Barry University School of Podiatric Medicine, “This type of equipment is very expensive and this type of hands-on experience is indispensible for our students.” Dr. Josh Bernard, Dr. Kyle Waggoner, Dr. Guillermo Donati and their staffs lead the seminars and labs.

WI Podiatrist Not in Compliance With State Board Order

In his past two reviews by a state board, Dr. John S. Lanham has not been able to comply with a state order meant to regulate his billing practices and other professional behavior. Yesterday, a state review committee gave Lanham "specific recommendations" to gain compliance with a state order.

Dr. John S. Lanham

Nearly one year ago, Public Investigator wrote about Lanham, a podiatrist who bills his patients much more than the average doctor. In one case, he billed $1,700 for medicine that costs $15 or less. Since that story, dozens of former and current patients of Lanham have written to Public Investigator expressing their frustration with the doctor and his billing.

Before that report, the state investigated Lanham on suspicion of fraudulent billing, suspended him for 90 days and issued the order he is still supposed to be following today. David Carlson, a spokesman for the state Department of Regulation and Licensing, said that Lanham is "still working on the same things that were in the board order last July."

Source: Ellen Gabler, Milwaukee Journal Sentinel [10/15/08]

Study Estimates Cost of ICD-10 Implementation

Implementing the new ICD-10 codes will cost the typical small medical practice (three doctors and two administrative staffers) $83,200 according to a new study conducted by Reisterstown, MD-based Nachimson Advisors, a healthcare information technology consultant.

The study was funded by 11 medical organizations, including the American Medical Association and the Medical Group Management Association, and it researched the costs associated with replacing the current ICD-9 codes with the new, more detailed ICD-10 system by 2011 as proposed by HHS.

Some of the costs would be one-time only, such as staff training, changing superbills to include 10 times as many codes, upgrading IT systems and insurance plan review, the study concluded. Cash flow disruption during the transition was listed as the second-largest cost, and would equal $19,500 for the typical small practice.

Source: Andis Robeznieks, Modern Healthcare [10/15/08]

Hiring Tips

A good question to consider - whether you're evaluating an employee or hiring a new one: Why does this practice need you?

Source: Adapted from Maxine Glover, CGA-Canada

Query: Atlas for Ultrasound Images

Is there an atlas of extremity ultrasound images?

Tip Sullivan, DPM, Jackson, MS

Editor’s note: The best text we’ve seen on the topic is “Atlas of Foot and Ankle Sonography” by Ronald Adler, MD, Carolyn Sokfa, MD, and Rock Positano, DPM, MSc, MPH (Lippincott Williams & Wilkins). See lww.com/product/?0-7817-4769-4

Query: *Q8* Modifier with CPT 11056?

Is it correct to put a "-Q8" modifer when billing CPT 11056 for Medicare.

Name Withheld by Moderator

Response: It is correct to append the "Q8" modifier to CPT 11056 if the patient was found to have two Class B findings.

If the patient does not have (or the chart does not document) two Class B findings, you would not append a "Q8" modifier to CPT 11056.

Mark Schilansky, DPM, Catskill, NY

Editor's note; Dr. Schilansky will be a featured speaker at the Codingline New York Meeting, January 22, 2009.

Codingline subscription information can be found here

RE: Arthrosurface Hemi Cap for Frieberg’s Infraction (William Sachs, DPM)
From: Sloan Gordon, DPM

I recently used this implant and was pleased with its use and the results; I have even scheduled another two cases. It takes practice to implant them with some pre-operative planning. While the sales rep was excellent, I encountered some of the typical 'behind the scenes discrimination' I see with many implant companies.

Specifically, the implants are handled by vendors, so you often don't know who makes the implants, what company actually sells, manufactures or performs quality control. In addition, like many companies, they are in the business of "selling" so that are pleased to 'allow' you to use their products. When I asked for a DVD of their procedure, I was hoping to see one of our surgical greats: "Mendocinos, Rubin, LaPorta, Pressman or Novicki or others" but what I got was an amateurishly-produced DVD .

Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

ASSOCIATE WANTED - SOUTH JERSEY

Part time/ Full time Full scope, well established group practice located between Phila. and the Shore. Digital X-ray, EMR, Diag U/S. Prefer PSR 24-36 individual with several years previous experience but will consider the right recent grad. Must be willing and able to provide quality palliative and surgical care. Medicare and NJ Blue Shield provider numbers is a plus. Competitive financial and benefits package. E-mail resume & references to: Toetrukr@aol.com

EQUIPMENT WANTED – AUTOCLAVE/CHAIRS

Wanted to buy – Used New Style (not pressure cooker) desktop digital autoclave (e.g. Midmark Ritter) and 2 waiting room chairs. Call 212-724-4457 or e-mail frottenberg@juno.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

EQUIPMENT FOR SALE – PAD SYSTEMS

2 SensiLase 3000 PAD Systems used for Skin Perfusion Pressure (SPP) & Pulse Volume Recording (PVR) tests for micro and macro-circulatory assessment. I’m selling because podiatrists no longer qualified to do studies and get reimbursed in Colorado. Paid $24,390. Sell for $20,000 each. Purchased from Vasamed. Call or e-mail Jack Burgin A Step Ahead Foot & Ankle Center 2001 S. Shields St., Bldg. F, Fort Collins, CO, 80526, (970) 232-1717 jack@asafoot.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

ASSOCIATE POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

WEEKLY SPECIAL - One week of ads (5x) for $89 One month of ads (20x) for $340 .

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