The Voice of Podiatrists

October 18, 2006 #2, 717 Editor-Barry Block, DPM, JD

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NE Podiatrist Offers Advice to High Heel Wearers

Omaha podiatrist DR. DAVID CORNELL said he does countless bunion operations, callus and corn removals, and consults on generalized foot pain. Cornell said one of the big culprits that sends women screaming into his office is high-heeled shoes. "It changes the way you walk, putting your center of gravity on the ball of your foot. The higher the heel, the worse it is," Cornell said.

DR. DAVID CORNELL

But rather than lecture women to deposit much of their shoe closet into the nearest Dumpster, Cornell counsels caution. "As a doctor, my job is not to make you feel guilty. My job is to support your lifestyle but provide info," Cornell said. "I don't complain, because it makes me a lot of business.”

Women can take steps to ease their pain. Start by letting your heel hit the floor for a few hours each day. "Alternate your footgear," Cornell said. "Spend two hours a day in a low shoe." Women who live in heels eventually can't wear flats. Perhaps the best way to combat high-heel aches and pains is to spend a little time on shoe and padding selection. "Most of those high heels -- the front part of the soles are very thin, even if it seems cushy," Cornell said. He provides patients with specially-made gel insoles, but said there are some mail-order and over-the-counter products that can act as shock absorbers for the ball of the foot, too.

Source: Shiloh Woolman, Internet Broadcasting [10/17/06]

McClellan Touts Income-Based Premiums For Medicare

Wealthier Medicare beneficiaries should be required to pay higher Medicare premiums to help ensure the program's long-term stability, former CMS Administrator Mark McClellan said on Monday in a speech at the Third National Medicare Congress, sponsored by Avalere Health and Health Affairs, CQ HealthBeat reports. The speech was McClellan's first since leaving his position at CMS.

McClellan said the agency should expand current plans to charge higher-income beneficiaries more for their Medicare Part B premiums. Beginning in 2007, individual beneficiaries with annual incomes of at least $80,000 will be required for the first time to pay an income-based surcharge on the standard Part B monthly premium. The new system will be phased in over three years.

McClellan said about 4% of beneficiaries, or 1.8 million individuals, will be required to pay the higher Part B premiums. The government projects that about 30,000 of those beneficiaries will drop out of the program in response to the cost increase, but McClellan predicted that those who drop out will later come back to the program when they need comprehensive coverage. He said Medicare is the best deal for seniors to obtain health coverage, even if premiums are increased.

Source: CQ HealthBeat via American Health Line [10/17/06]

January 18, 2006 ("The day before the NY Clinical Conference") - Marriott Marquis

Topics: Medicare & CPT 2007 - DME Update - Audits - Routine Foot Care - Surgical Coding - Forms in Practice - Modifiers - Audits - Q&As
Speakers (tentative): Barry Block, DPM, JD; Harry Goldsmith, DPM; Mark Schilansky, DPM; and Paul Kesselman, DPM.

Go to or click on www.codingline.com/events-ny.htm for details and registration information.

For a list of all meetings go to: www.podiatrym.com/meetings.pdf

Query: Source For Office Brochures

Does anyone have an office form that they utilize to promote their office such as an informational brochure about the podiatrist, staff, insurances and general policies regarding appointments, etc? I have seen some advertised, but do not recall where and would be most grateful for any assistance.

Chuck Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com

Query: Inexpensive A-O Fixation Set

Does anyone have a resource for an inexpensive A-O screw fixation set for an office environment. All I need are non cannulated 2.7 screws and the instrumentation to fixate them. I have seen some that were over five thousand dollars.

David Gutierrez, DPM, Bronx, NY

Query: Intermetatarsal Neuroma Coding

Can someone please expain the difference between CPT 28080 (excision, interdigital [Morton] neuroma, single, each) and CPT 64782 (excision of neuroma; foot, except digital nerve)?

I know to use CPT 28080 for interdigital neuromas. I have a doc that wants to use CPT 64782 for excision of neuroma in the 3rd inter-metatarsal space. When I asked why isn't he using CPT 28080, he replied, "There is no difference in the codes." Obviously, there is a difference otherwise there would not be two different codes.

Deb Carr, CCS , Enola, PA

Response: If your surgeon is reporting CPT 64782 (excision of neuroma; foot, except digital nerve) for excision of a Morton's neuroma, then he/she is reporting a CPT code for a procedure that was not performed.

A Morton's neuroma is a thickening of the tissue around one of the digital nerves leading to adjacent toes. The description associated with code, CPT 64782, indicates that the code is not to be used for excision of digital neuromas; therefore, it is inappropriate to use this code for a Morton's neuroma excision.

Heidi Stout, CPC, CCS-P, New Brunswick, NJ

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

RE: End ABPS Board Certification at 60 (Arden Smith, DPM)
From: Kenneth Meisler, DPM, Richard Frost, DPM

I am board certified by the ABPOPPM and ABPS and have been recertified by both. I agree that after 30 years of practice ABPOPPM has the right idea by not asking us to recertify. ABPS will require me to recertify again while those that were "grandfathered" in never have to recertify. I suggest ABPS follow ABPOPPM's lead and end recertification after 60.

Kenneth Meisler, DPM, New York, NY, kenmeisler@aol.com

I disagree with Dr. Smith regarding not recertifying (ABPS) after age 60.
"For what should be obvious reasons to all of us, both our exam taking ability and our ability to study is usually quite different after about age 60 than it was when we were younger; as is the toll that this whole process takes on one's practice, family life, and total well-being as one matures both in practice and in life."

For reasons he states ("exam taking ability, ability to study"), I would argue that is why you should have to take the exam to recertify. I believe being Board certified connotates an ability/experience above the average practitioner and should not be 'diluted' or lessened by allowing a lesser standard for some. If you are not able to pass the exam, you are not recertified. Recertification to me denotes a certain sacrifice to stay current and up to date.

Yes this does take some sacrifice, as it should. Being ABPS certified is one area of professional satisfaction for me. The same could be said for auto drivers over a certain age. They have years of practice, but I would argue that not all should be driving due to deterioration of physical and/or mental abilities, as well as the "stress of driving.”

Richard Frost, DPM, Spokane, WA, rfrost@rockwoodclinic.com

ASSOCIATE POSITION - BRONX, NY

Podiatrist wanted two days a week(with full-time growth potential). One day working in a busy Bronx office, one day making house calls. Base salary + incentives. Golden opportunity for a podiatrist to join up with a very ethical, hard-working and successful DPM. Please email CV to: Scottdeis@aol.com

ASSOCIATE POSITION – ARIZONA

Excellent opportunity for an experienced looking for a change or young podiatrist looking to jump start their practice. Podiatry practice is well established over 25 years, successful and a large volume in the Phoenix metro area. A current AZ License preferred as the position is available immediately. The right person will join as a salary associate leading to partial ownership in the group practice. Position available immediately. Email CV and inquiries to:scfcs@cox.net

PODIATRY POSITION IN ALABAMA

Excellent opportunity for immediate opening with AL licensee. Practice is very busy, 2 locations in West AL. Opportunity of six figures first year with contract for stock ownership. Great place to practice and raise a family. Get started with no hassles of a start-up practice. Very modern offices with ongoing management. Fax resume to (205) 330-9920 and visit our website at www.myfeethurt.com

MEDICAL EQUIPMENT WANTED

MinXray P-200 Exposure Hand Switch with Timer Control (circa 1977). jim.fractal@gmail.com

SEEKING ASSOCIATE POSITION - NEW YORK

Hardworking, ethical and well trained PSR-24 trained podiatrist seeking a part-time associate position in Westchester county or surrounding areas. Please contact (206) 919-2832 or bbrick2@yahoo.com.

ASSOCIATE POSITION-INDEPENDENT CONTRACTOR – FLORIDA

High Income position for ethical hard working podiatrist, great for semi-retired or to supplement office practice, part time. Must have Florida license and active Medicare/Medicaid numbers. FAX CV or Resume to 727-785-4697

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.com
WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well established podiatry practice in Mt. Airy, North Carolina that is either for sale or in need of an associate/partner to come on board to take over patient care. Dr. Hodges unexpectedly passed away in January 2006, leaving approximately 3,500 patients without a podiatrist to care for them. This is a unique opportunity to be able to begin work in an extremely busy podiatric practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

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

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