The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

November 24, 2007 #3,100 Editor-Barry Block, DPM, JD

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CA Podiatrist Uses Personal Story to Inspire Women to Pursue Their Dreams

Dr. Holly Spohn-Gross, was the keynote speaker at a luncheon held by The Kern River Valley Committee of the Women's and Girls' Fund, and moved the audience to tears with her tale of growing up with a cleft palate and cleft lip. She spoke of the pain of being ridiculed as a child, not only by the other children, but by her own mother, as well. 'All of us have flaws and scars that we hide,' said Spohn-Gross. 'I couldn’t hide mine; it was right there on my face.'

Dr. Holly Spohn-Gross

Wanting to be noticed and appreciated, Holly began running, and was soon the star of her high school track team. In fact, she did so well that she received a scholarship to Western Michigan University, where she ran track until she got stress fractures and couldn’t run on the team any longer. She had the desire to become a doctor, and was not going to let anything stop her. 'My advisors told me I couldn’t do it, my mother told me I couldn’t do it, but I believed I could,' she said. '’Dream, reach, and believe,’ became my motto.'

Spohn-Gross encouraged all of the women and girls in the audience to be strong and pursue their own dreams with determination and tenacity. 'It is pain that defines us as people; no one can overcome life’s obstacles without enduring pain. You are women and by default have to overcome adversity. To take responsibility is to take control, and it is up to you to do this,' Spohn-Gross said.

Source: Kern Valley Sun (CA) [11/21/07]

Brim Re-Appointed to WA State Podiatry Board

Governor Chris Gregoire has announced that Stewart Brim, D.P.M. of Spokane has been reappointed to a term effective October 29, 2007, ending June 30, 2012. Brim is in private practice at the Medical Foot Center in Spokane and is the medical director of the Spokane Surgery Center. He is a member of the American Board of Podiatric Surgery and the American College of Foot and Ankle Surgeons.

The Board examines candidates for licensing or registration; investigates charges of malpractice, unsafe conditions or unprofessional conduct; conducts disciplinary hearings and recommends and adopts rules and regulations to promote the safety and protection of the public.

Source: WA State Governor’s Office [11/21/07]

HRAs Replace Traditional Retiree Benefits as Employers Scramble to Reduce Costs

Health reimbursement arrangements (HRAs) are slowly replacing more traditional retiree health benefits as large and jumbo employers hunt for ways to reduce costs while retaining coverage, industry observers say.

"This is a definitely a trend for large companies that offer retiree benefits. We started noticing it about five years ago, and it has continued to strengthen," says Frank McArdle, who heads up the Washington, D.C., office of Hewitt Associates. "As more companies move in this direction, it gets the attention of other employers." The trend is likely to pick up steam, McArdle predicts, but will be slower to catch on among employers that have a union population. Unions have traditionally opposed account-based health plans because they are seen as a reduction in benefits.

According to a Sept. 27 Wall Street Journal article, Kellogg Co. last month told 1,000 Medicare-eligible retirees from its Keebler unit that their health coverage would be replaced by an HRA as of Jan. 1. Moreover, Ford Motor Co. will replace its group coverage for 57,000 salaried retirees and their spouses with an annual $1,800 HRA contribution on Jan. 1. Retirees will put those dollars toward individual coverage or to supplement Medicare coverage.

Source: Inside Consumer-Directed Care [11/21/07]

Query: Fracture and Laceration Coding

A new patient presented to the office after banging her 5th right toe. The injury resulted in a fracture of the proximal phalanx that was displaced, and a laceration at the sulcus of the digit. I injected local anesthesia, manipulated the proximal phalanx back into position, and sutured the laceration. Any ideas on how to bill this?

Adam Klein, DPM, Lynbrook, NY

Response: Your clinical description indicates the following :

CPT 28510 - closed treatment of fracture, other than great toe, with manipulation

CPT 12001 - simple repair of superficial wound, hands and feet, 2.5cm or less.

Note that the fracture code has a 90-day Medicare post operative period while the laceration repair has a 0-day post operative period.

Howard Zlotoff, DPM, Camp Hill, PA

Codingline subscription information can be found at:
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RE: MRI Compatibility (Jeffrey Kass, DPM)
From: David T. Taylor, DPM

A metallic implant (pins, screws, wires, etc.) in the foot or ankle is not a contraindication for an MRI of the lower extremity or anywhere else in the body. Obviously, the image adjacent to the hardware will be distorted. Even if the implant is stainless steel and thus ferromagnetic, there is negligible (if any) risk for significant displacement of stable hardware.

For example, the notion that an MRI can't be done on a patient with a possible acute Achilles tendon tear that has had prior forefoot surgery with a metallic implant of any kind is false. Let's put to rest this example of inaccurate medical dogma.

David T. Taylor, DPM, Flint, MI, dttaylor_19@yahoo.com

RE: Failure to Return Insurance Overpayment (Name Withheld)
From: Steven Repitor, DPM, David Secord, DPM

I regularly return insurance overpayments, ALWAYS ! Do it right away. Your practice is asking for trouble. Have a conversation with your bosses and tell them the profession expects them to do the right thing ASAP.

Steven Repitor, DPM, Detroit, MI, sjr1234@comcast.net

Good luck having anyone pay attention to you if you report this to the authorities. When I bought my practice, we did an internal audit of a random 3-month period of the practice under the former owner and found (within just that 3 month period) $18,636.09 not refunded to patients or insurance companies. This was reported to the state of Texas insurance commissioner and the Attorney General, Medicare, Medicaid and all the private insurance companies involved. Nothing happened.

As far as I recall, the Texas Podiatric Medical Association) and American Podiatric Medical Association were contacted as the Texas State Board of Podiatric Medical Examiners and no one contacted me or paid notice. As far as I can tell, crime pays—if you can look at yourself in the mirror in the morning.

David Secord, DPM, Corpus Christi, TX , David5603@pol.net

RE: Billing Insurance Companies For Free Exam (Name Withheld)
From: Bryan C. Markinson, DPM

Podiatrists in many instances offer their services for free such as community or hospital screenings, church events, organizational health fairs, etc. Everyone appreciates this type of activity.

However, the days when we offer services from our offices for free consultations where the only real hope is that the person responding has good insurance for the moment the "consult" is over, and "treatment" begins, should be long over. Those of us who continue this practice, do so along with trial attorneys (who work on contingency anyway), cosmetic huckster dermatologists and plastic surgeons (a specialty which cannot be compared). No other self-respecting group of medical practitioners offers free consultation.

While the offering of "free anything" may have proven itself to be a way to get people in the office, the offering itself becomes your most compelling credential. That is very sad. If you think that the public is impressed by "free," try charging $200.00 dollars or more for your initial consult to those who call without insurance or have high deductibles. After a year, let me know which method brought in the most income. I already know which one will impress more.


Bryan C. Markinson, DPM, New York, NY, bryan.markinson@mountsinai.org

RE: Lytec EMR
From: Peter Gensheimer

There are some useful sources of information regarding Lytec and MediNotes. There is a Google user group with nearly 200 members. It is free to join and anyone can post questions. To join go to http://www.medpipes.com/support.htm#GoogleGroup and simply enter your email address.

In addition to the Google Group, there is also an entire website devoted to Lytec training: www.learnlytec.com

Peter Gensheimer, Simsbury, CT, support@medpipes.com

Excellent opportunity for ethical & personable hard-working individuals to join a busy multi-office two physician practice. Looking for one podiatrist with interest in conservative care, including sports medicine and one podiatrist trained in rearfoot surgery. Rearfoot surgeon must be board eligible and working toward board certification. Competitive salaries, 401-K, health insurance, paid vacation and more. Please forward CV with references to nrussell@neondsl.com

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

We specialize in providing conservative care to residents in long-term care settings. Immediate part-time positions available. Very flexible scheduling. Competitive compensation and expenses. Contact Dr. Brian Aronson. Phone-773-775-0300, or Fax resume to 773-775-0883

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