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| PM News | |
The Voice of Podiatrists
Serving Over 17,790 Subscribers Daily
December 06, 2016 #5,812  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2016- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
Quick Poll
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How familiar are you with MACRA? |
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| INTERNATIONAL PODIATRISTS IN THE NEWS | |
Pediatricians Often Miss Diagnosis of Valgus Foot: Dubai Podiatrist
According to Dr. Jörg Stöbel, a German Board-qualified podiatrist and general manager of the Chiropody Center in Dubai, GPs and pediatricians are to blame for so often missing in children a diagnosis of valgus foot – a condition in which the foot is twisted out of normal position or there is an outward turning of the heel.
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Dr. Jörg Stöbel |
"How many times has your pediatrician taken a look at your daughter or son to make sure they are running properly?" he asks. "Probably never. This isn’t the case just in the UAE – this is a problem worldwide. It’s not part of the medical community’s education, and there’s no awareness, so no one is checking for this."
Source: Hala Khalaf, The National [12/4/16]
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| FROM PM's CURRENT ISSUE | |
Twice a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
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Today's Featured Article |
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
The Basics of Incident-to Billing - Part 6
Employing non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, etc.) is an effective way to increase productivity in a physician office. However, under Medicare rules, covered services provided by non-physician practitioners (NPPs) are reimbursed at a reduced rate (85 percent of the fee schedule amount). The “incident-to” billing rules provide an exception, allowing 100 percent reimbursement for non-physician services that meet the requirements detailed in the Medicare Benefit Policy Manual, Chapter 15, Section 60 (Services and Supplies Furnished Incident To a Physician’s/NPP’s Professional Service).
There are six basic requirements to meet the incident-to guidelines for Medicare payment:
6. The incident-to service must be the type of service usually performed in the office setting, and must be part of the normal course of treatment of a diagnosis or illness. The Benefit Policy Manual elaborates:
Where supplies are clearly of a type a physician is not expected to have on hand in his/her office or where services are of a type not considered medically appropriate to provide in the office setting, they would not be covered under the incident-to provision.
Source: G. John Verhovshek, MA, CPC, Physicians Practice [11/23/16]
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| QUERIES (NON-CLINICAL) | |
Query: Starting a Practice from Scratch
I am interested in starting a new office from scratch. I previously had two offices in Massachusetts in the '90s but sold them. There wasn't technology like today, so I am a bit lost and I'm looking for some guidance as to what equipment I need to run a practice in 2017.
Wayne McCullough, DPM, Frankfort, IL
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| CODINGLINE CORNER | |
Query: Orthotics and PF Straps
We recently received a denial when we billed for foot orthotics and a plantar fasciitis strap on the same day. Can anyone tell me if this is billable?
Danielle LaLonde, Belvidere, NJ
Response: Likely not. It seems implausible that you would be strapping the foot and providing the patient with custom foot orthotics on the same day. Grounds for appeal could be that you did not expect the patient to wear the devices all day and that they are to be used on a trial basis for the first two weeks, with increasing use by one hour more per day. Thus, the need for strapping on the same date as the dispensing. Your notes would have to substantiate this.
For most of the notes on foot orthotics I have reviewed, this would not seem to be the overall trend and it would be an exception. Thus, the need to improve one's dispensing notes documentation is apparent. I would also be cautious about this because if the case is rather that you are billing for the foot orthotics prior to dispensing (e.g., date you are casting) and this is not in accordance with the insurance carrier's policy, this would definitely be inappropriate. The payer would not know that you did not dispense the device, and your appeal would indicate that.
Paul Kesselman, DPM, Woodside, NY
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS (CLINICAL) - PART 1 | |
This might be a contact dermatitis due to the cleanser, Aquaphor, dressing, or pad adhesive. Try changing to a saline cleanser, hydrogel, or different dressing/cushion, and see if that helps.
Judd Davis, DPM, Colorado Springs, CO
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| RESPONSES/COMMENTS (CLINICAL) - PART 2 | |
From: Ivar E. Roth DPM, MPH
As I remember when I read the study concerning Betadine toxicity, it showed that there was a statistically significant correlation, but that was only a couple of percent to make it a positive study in an in-vitro study. In reality, there is nothing better than a wet-to-dry Betadine dressing. In my over thirty years in clinical practice, I have never been let down with using Betadine. When the rubber meets the road, I vote for Betadine.
Ivar E. Roth DPM, MPH, Newport Beach, CA
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| RESPONSES/COMMENTS (EMR) | |
From: Steven J. Kaniadakis, DPM
All I can offer is using "House DR", an electronic super-bill. House DR is designed to enable you flexibility to change EHR/EMR programs and billing and coding companies (and people). If you decide to use Practice Fusion (PF), then you will need to choose an electronic super-bill. Kareo now has their own EMR. Kareo was the main billing company for PF. If it were me, I would use a billing company astute to the nuances of billing, and maybe a podiatrist's coding as well. Flexibility to adapt to change is the key feature you should be looking for at this stage of your practice.
Steven J. Kaniadakis, DPM, St. Petersburg, FL
Disclosure: I invented the House DR electronic Super-bill program
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1A | |
From: Michael M. Rosenblatt, DPM
There is considerable controversy about Dr. Pamela Karman's appointment to the NY State Podiatry Board. She has served in "a number" of expert testimony cases against DPMs. Podiatrists envision themselves as "soft targets" and have an understandable enmity against those who "frequently" align themselves with the plaintiff's bar. There is one obvious conflict of interest: We would automatically assume that she would recuse herself from ANY Board action where she had even a passing contact with a DPM under NY Board focus, even if she didn't testify. This would even include her reading of chart notes.
Aside from this issue, we wonder about "fairness." Some Board members are tough as nails and some seem fair. This is a moving target and hard to identify in advance. How do you know until they are seated and do some actual Board-issue voting? So far, she has elected not to comment in PM News. That is her privilege. But a brief note from her might help allay NY DPMs' fears, among them some who (someday) might sit under the NY Podiatry Board microscope. Anyone can....it happens all the time. I believe all we ask is that she is "fair" in her new seat of power. So far we don't know. In the minds of those whom she testified against, it is safe to assume what their opinion is. Do you believe she has an unstated obligation to allay their fears? Should she resign?
Michael M. Rosenblatt, DPM, San Jose, CA
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1B | |
From: Alison D. Silhanek, DPM
Several respondents have noted concern over the appointment of Dr. Pamela Karman to the NY State Podiatry Board. I think that “concern” is not an adequate response. “Outrage” may be more appropriate. The NY State Department of Education has tasked the NY State Podiatry Board with overseeing my license, making sure that I am in compliance with the various regulations and bylaws. First off, momentarily ignoring this appointee’s seat on the plaintiff’s expert bandwagon, let us look again at her credentials.
I realize that this forum has had vigorous debates about the fairness of some of the board certification requirements. Let us put that aside and hopefully agree that a person charged with overseeing my (and all NY podiatrists’) license should have successfully undergone the arduous process of...
Editor's note: Dr. Silhanek's extended-length letter can be read here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoes of the Day
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Worn this week as part of the NFL's Cleats for a Cause campaign |
Source: National Football League
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MEETING NOTICES
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| CLASSIFIED ADS PART 1- ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCATE POSITION – GEORGIA
Village Podiatry Group, a wholly owned subsidiary of Extremity Healthcare, Inc. is seeking board qualified/certified associates with a Georgia license. Ideal candidates have 3-5 years’ experience and knowledge of coding/billing, and desire to excel while utilizing our practice owned ancillaries. Our successful model is built to enrich the physicians and their efforts. Serious inquiries only to Tony Brzezicki, Human Resources, at tbrzezicki@extremityhc.com or fax (770.874.1748). Starting salary will be based on experience and the value you bring to the practice. EHI also offers a competitive benefits package.
F/T OR P/T PODIATRIST- PENNSYLVANIA
Expanding, well rounded, multi-site, state-of-the-art group with offices and Nursing homes throughout Lehigh County, Pennsylvania. We offer: Competitive salary Benefits, paid time off, partnership opportunity We're associated with hospitals, wound care centers, and a residency program. Requirements: Hard-working, self- motivated, Non-Surgical OK 2017 graduating residents welcome. Please email CV to: recruiting@foi-solutions.com
PODIATRIST WANTED - NORTHERN NEW JERSEY
Graduating in 2017 or existing podiatrist looking for a change. Must be go getter and work well with others in great opportunity. Confident forefoot and rearfoot /ankle training a must. podiatrydocsnj@gmail.com
ASSOCIATE POSITION - EASTERN SHORE OF MARYLAND
Seeking highly motivated, ethical, enthusiastic associate to join successful, well-established practice located in close proximity to Maryland and Delaware beaches. Certified/qualified by ABPS with rearfoot experience preferred. The practice incorporates surgery, wound care, sports medicine and general podiatry. Fully equipped office with diagnostic ultrasound, fluoroscopy, vascular testing, radio frequency ablation, six treatment rooms and three satellite offices. Main office has accredited ambulatory surgery center. This opportunity has excellent salary potential with benefits for the right individual. Send CV to dpmkthomas@gmail.com.
ASSOCIATE POSITION - SPRING HILL/CITRUS COUNTY AREA OF FLORIDA
Community Health Solutions of America (CHS) has a territory opening in the Spring Hill/Citrus County area of Florida for a mobile podiatric physician. Physicians must maintain an active Medicare and Florida licenses. Expenses including malpractice insurance, medical supplies, travel allowance, etc. are covered. Exceptional benefits include paid holidays, vacation, health insurance and 401K retirement plan with company match. First year six figure salary is guaranteed! Second year profit sharing. Most 2nd year doctors earn $150,000 and up. Email CV to psojobs@chsamerica.com.
POSITION AVAILABLE - LOS ANGELES, CA
Multi office, multi physician foot and ankle surgical practice looking for highly trained foot and ankle surgeon to join our growing group. Practice emphasis on sports medicine, reconstructive foot and ankle surgery and revision surgery. Prospective candidate must have excellent personal skills and work well with a team. Competitive compensation and 401K, profit sharing, health insurance, dental and vision insurance. Surgical center partnership potential and full scope hospital privileges available. Facility is state-of-the-art with PT, CT, MRI, ultrasound and digital x-ray all in office. New graduates are welcome. Interviews prior to and at ACFAS in Las Vegas. Contact us at: bbaravarian@mednet.ucla.edu
ASSOCIATE POSITION – NEW YORK
Seeking motivated PMS-36 trained podiatric surgeon for full-time associateship in group with offices in Manhattan, Queens, LI, and and the Bronx. Offering competitive salary with room for growth. Surgical-based practice - special emphasis on trauma, reconstruction, rearfoot and ankle surgery. Please email resume to: nypodrecruit@gmail.com
ASSOCIATE POSITION - UPSTATE NY
Rapidly growing practice seeks associate to join and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Partnership starts beginning year 2 based on per-established criteria. Contact: docryanlee@gmail.com
ASSOCIATE POSITION - NEW JERSEY
Doctor needed in south Jersey for expanding practice. Multidisciplinary setting. Six figures. No weekends. Must be both conservative and surgically capable. ABFAS certified/qualified. jennberlin1@gmail.com
1 YEAR RECONSTRUCTIVE FELLOWSHIP
Requirements graduate of PM&S36, CV, board scores, school transcript. in service exam scores for ABFAS. Common cases to expect, Rods, Illizarov, hindfoot & midfoot fusions. Adult/pediatric flat foot. ACFAS poster to be done. Energetic, well spoken & efficient. BQ in RRA by end of residency. 55k / yr www.fflcreconfellowship.com klamdpm@hotmail.com
PM NEWS CLASSIFIED ADS REACH OVER 16,500 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 16,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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| CLASSIFIED ADS PART 2- PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE- MASON CITY, IA
Well-established, full range, solo podiatry practice for 34 years. Located in professional building next to hospital. Fully equipped with digital x-ray system. Currently 3 days/w3ek, 5-year average gross $409K and $265K net with growth potential. Call 641-423-1565 after 5PM (CST) or e-mail sbrau@mchsi.com
PRACTICE FOR SALE – REDUCED TO SELL- WESTERN MASSACHUSETTS
State-of-the-art medical suite renovated 4 years ago Modern equipment, prime location, large physician referral base, full hospital privileges. No house calls, nursing homes or hospital ER call. Established patient base and unique opportunity for surgically-oriented podiatrist in the Berkshires. Will transition, if desired.. Contact: drross@albany.twcbc.com or 413-443-2468.
PRACTICES WANTED - NEW JERSEY
Practice looking to expand through acquisition and/or merger. Ideal locations within one hour of NYC. Opportunity to receive cash for your practice. NJAssoc@comcast.net
PM NEWS CLASSIFIED ADS REACH OVER 16,500 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 16,500 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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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.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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