The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

October 17, 2007 #3,068 Editor-Barry Block, DPM, JD

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Study By AZ Podiatrist Shows Healing Capability of Medihoney

Comvita confirmed today that its partner in the US, Derma Sciences, has successfully launched its new range of Honey based wound dressings. Derma Sciences launched the Medihoney® brand, under a global brand co-operation agreement with license owner Comvita. The dressings were launched at the Clinical Symposium on Advances in Skin and Wound Care (CSASWC) based in Nashville, TN.

Dr. Robert G. Frykberg

In a clinical study Robert G. Frykberg, DPM, MPH Chief of Podiatric Medicine and Surgery at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix, AZ presented a case series of Medihoney dressing in several patients with diabetic ulcers. Results were positive wound healing outcomes, and bioburden control even against such drug resistant pathogens as MRSA.

In addition to authoring numerous scientific manuscripts, Dr. Frykberg has edited two of the most widely circulated textbooks on the subject of Diabetic Foot Care. The importance of podiatry to the woundcare market is significant with leg ulcers and diabetic foot ulcers making up a significant percentage of the total market for advanced wound care.

Source: ShareChat (New Zealand) [10/15/07]

OK Podiatrist Finds That He’s a “House Archeologist”

The love letters were the first clue. Norman physician Charles “Chuck” Anderson was putting a floor down in the attic of his family’s newly acquired two-story home at 306 Chautauqua Ave. with 2-by-4s and plywood so they could store their Christmas decorations.

Dr. Charles ChuckAnderson

Anderson had already found a 1913-postmarked postcard as he ran a cable down a wall when they first moved into the venerable yellow frame house with white trim about three years ago. And he was sifting through the old insulation in the attic before flooring it when he found more treasures.

“I love you my wife-to-be,” read one letter to Addie Maloy from her fiancé Terrence Westhafer at the University of Illinois, which also happened to be the school where Anderson graduated. The yellowed letter was one of three written in 1915 and 1916 to the daughter of the couple who built the house, P.A. “Pumphrey” and Nettie Maloy. It was simply addressed to “Miss Addie Maloy, Norman, Okla.” The find turned Anderson into an amateur sleuth and self-proclaimed “house archeologist.”

Read Full story at: www.normantranscript.com/localnews/local_story_287000228.html?keyword=topstory

Source: Carol Cole-Frowe, Transcript [10/14/07]

CMS Announces New Income-Based Premiums

While the standard monthly Medicare Part B premium in 2008 will remain less than $100, the roughly 5% of individual and married enrollees with higher incomes will pay more if they choose to remain in the outpatient program.

Source: Centers for Medicare & Medicaid Services via AMNews [10/22/07]

Query: Best Way to Find Employees

What is the best way to get experienced, motivated, and honest employees with some billing knowledge?

Joseph Borden, DPM, Reseda, CA

Query: Coding Excision of a Scar

I have a patient with a scar post arthroplasty (performed by another surgeon), right 5th toe. After one year, she decided to have it removed since it was becoming more painful for her, especially when wearing a shoe. An elliptical incision was made encompassing the scar (the scar was 3 inches long; the lesser margins were about 1/4 inch each), which was removed and the skin closed with 4-0 nylon.

What ICD-9 codes should be used? And what CPT code would be billed?

David Zuckerman, DPM, Woodbury, NJ

Response: If the arthroplasty scar itself is 3 inches in length (7.62 cm), and you included 1/4 inch margins on either side of it, you would add both margins and the length (in centimeters) together (7.62 cm + 0.635 cm + 0.635 cm) - this equals: 8.9 cm. And look up 8.9 cm under the CPT 1142x code series for the proper code.

That code would be CPT 11426 (excision, benign lesion including margins, except skin tag (unless listed elsewhere), feet; excised diameter over 4.0 cm). The are diagrams in the guideline section for "Excision - Benign Lesions" section in the CPT book to help determine the "size" of the lesions.

Tony Poggio, DPM, Alameda, CA

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

RE: Board Certification Requirements for Hospital Staff (Doug Milch, DPM)
From: Multiple Respondents

One of our hospitals just went through the same exact issue. During my research, I learned that there are hospitals that only request that the applicant present documentation proofing that they are trained or have performed the requested surgical privileges. They only get credentialed for those procedures and the hospital does not require a specific board certification. Our credentialing board was persistent on having some type of board certification. They used to only accept ABPS as a certifying Board.

To resolve the issue for those who are not and cannot be board certified by ABPS (but have been in practice for many years), we presented the credentialing board with APMA documentation. APMA recognizes two certifying Boards (the ABPS and ABPOPPM). We also removed the time needed to be board certified. Instead we included that the applicant has to be in good standing with the certifying board. I can send you a copy of our newly modified rules & regs if you like.

Roya Mirmiran, DPM , Albuquerque, NM, rmirmiran@pol.net

I think the answer is very clear, of course putting politics and other wasteful dialogue aside. All qualified podiatrists should be allowed staff privileges. Being ABPS certified does not correlate with surgical savvy or skills. As a matter of fact, I personally know several podiatrists that are ABPS certified that would not be allowed to work on my pet.

For podiatry survival, we need to be inclusive and get rid of the exclusive clubs. And yes, I am ABPS certified and re-certified.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

The way our hospital handles this scenario is that most members of most sections need to be board certified in a certain time frame, e.g. for podiatry 4 years after completion of residency, need ABPS certification. This way, it's the same for all specialties where board certification exists. It levels the playing field and is non-discriminatory.

When an individual applies to the hospital, they sign their application with an acknowledgment attesting if they do not become board certified within the specified period of time, they must resign. We had one individual w/o certification and we 'grandfathered' him due to experience. Regrettably, that was a mistake and likely won't be repeated.

I believe some minimum standard is necessary, especially one that works for your community and that most members can live with.

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

Medicare Conditions of Participation, 42 CFR, 482.12 (a) (7) that went into effect in 1993, states that the governing body of a hospital must ensure that under no circumstances the accordance of staff membership or professional privileges in the hospital is dependant solely upon certification, fellowship or membership in a specialty body or society. If the hospital does require the above, they can lose all Medicare reimbursements. E-mail me with a fax number for a copy of the Code of Federal Regulation.

Mike Boxer, DPM, Woodmere, NY, mcbdpm@aol.com

Editor’s Note: Extended length letters by Howard Lazar, DPM, JD and Bryan Markinson, DPM appear at: http://www.podiatrym.com/letters2.cfm?id=16140&start=1

ASSOCIATE POSITION – SOUTHERN CALIFORNIA

Seeking a position in a warm, friendly, and productive environment? Well, look no further! A well established podiatry facility in North Hollywood, California has an immediate position available for a podiatrist. He/She must be motivated, reliable, and dedicated. Depending on performance, partnership is possible. If interested, email your resume to drnickoghosyan@yahoo.com

ASSOCIATE POSITION CLEVELAND CLINIC

The Section of Foot and Ankle Surgery at Cleveland Clinic is seeking highly qualified board-certified/ board-eligible podiatrists to join our faculty. High volume clinical practice consisting of general podiatric care, wound care, and diabetic foot problems, along with a research background in diabetic foot complications and/or clinical outcomes. Please contact: Joe Vitale, @ vitalej@ccf.org

THE PERFECT CHRISTMAS GIFT

Super Luxurious Custom Oceanfront Dreamhouse on Caribbean island of Bocas del Toro, Panama. FULLY FURNISHED 5000 SQ FT, 5 BED, 5 BATH, 2 KITCHENS, Infinity Pool, satellite TVs, wireless internet, Lush Tropical landscape, NEVER hurricanes. NO TAXES for 20 YEARS. $875,000. photos & info drritarae@yahoo.com

SALES REPS WANTED

Orthofeet is looking for independent sales reps to sell their line of shoes and orthotics. Orthofeet offers high end shoes and diabetic insoles that are covered by Medicare, along with competitive advantages and unique selling points. E-mail: mb@orthofeet.com

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