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| PM News | |
The Voice of Podiatrists
Serving Over 17,220 Subscribers Daily
December 09, 2015 #5,545  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2015- 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 will the shift from fee-for-service to value-based payments affect podiatry? |
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| PODIATRISTS IN THE NEWS | |
NH Podiatrist Discusses Functional Vs. Structural Hallux Limitus
According to Howard Dananberg, DPM, "Functional hallux limitus is a term first described in podiatry literature in the '70s to describe a precursor to structural hallux limitus. In 1984, I published the first of 30-plus papers on this subject and linked this entity to dysfunctional foot pronation, as well as the chronic recurrence of lower back pain."
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Dr. Howard Dananberg |
"FHL can be defined as a condition of the great toe joint in which normal motion is present on non-weight-bearing clinical exam, but during the single-support phase of weight-bearing, range of motion is completely blocked. Since it is most commonly avoided during walking, it may not show any signs of inflammation or pain. Other sites in the foot may be stressed, but since the great toe joint shows normal motion and a lack of any symptoms, it is rarely seen as the etiology to many common foot and postural ailments," said Dr. Dananberg.
Source: William E. Morgan, DC, Dynamic Chiropractic
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| PODIATRISTS AND SPORTS MEDICINE - PART 1 | |
Running Shoes Need Replacement After 300-400 Miles: FL Podiatrist
The life span of athletic sneakers depends on the brand and style within that brand, says Dr. Cary Zinkin, an American Podiatric Medical Association spokesman and podiatrist in Deerfield Beach, Florida. “The average running sneaker will last about 300 or 400 miles, depending on the sneaker,” says Zinkin, an avid marathon runner. Some are made with materials that may wear down sooner than others, he explains. You can figure out if your sneakers are worn by placing them on a flat table and examining how they sit. Are the soles turned in or turned out? Do they not lay flat? Zinkin says that indicates both the interior and exterior are past their prime.
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Dr. Cary Zinkin |
Another test is to try on a new pair. If the new pair feels genuinely more comfortable, it may be time to replace those old kicks. What if you don’t? “They could cause you to compensate, leading to shin splints, heel pain, knee pain, or even cause a stress fracture for long-distance runners,” Zinkin says. “Foot pain is never normal, and anyone that experiences foot pain ongoing for more than a few days should see a podiatric physician.”
Source: Samantha Costa, U.S. News & World Report
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| PODIATRISTS AND SPORTS MEDICINE - PART 2 | |
Many Running Surfaces are Unsuitable for Barefoot Running: IL Podiatrist
Dr. Beth Jarrett, podiatrist and professor at Rosalind Franklin University of Medicine and Science, says that unfamiliar roadways for barefoot runners present the real risk. “Probably the bigger issue in terms of injuries with barefoot running is the fact that you’re barefoot, and more likely to step on stones or glass,” she said.
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Dr. Beth Jarrett |
Dr. Jarrett says she would not generally recommend barefoot running, unless someone had access to a safe running environment to minimize the risk of injuries from unfamiliar surfaces. As Dr. Jarrett says, if people are not already runners, they shouldn’t try barefoot running out of the blue. “It’s important to remember that just as not everyone is meant to be a runner, not everyone is meant to be a barefoot runner,” she said.
Source: Yasmin Rammohan, WTTW
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| PRACTICE MANAGEMENT TIP OF OF THE DAY | |
Maximize Your Practice Management System - Part 3
2. Recurring credit card payments
This is a brilliant way to let technology do the patient collections automatically — no ongoing human intervention required. Here's how this works: Staff swipe the patient's credit card into the system. The patient agrees to a monthly payment amount and number of months. The credit card is automatically charged monthly until the account is paid off. All this for a small discount fee from the credit card processing company to the practice, which is often negotiable based on your transaction volume.
Frankly, in an age of technology and rising deductibles, it's the only payment plan we recommend. And, it complies with payment card industry regulations, which, by the way, keeping a spreadsheet of patient names and credit card numbers "on file" in a drawer does not.
Source: Karen Zupko, Physicians Practice
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| QUERIES (CLINICAL) | |
Query: Off-loading Charcot
A 79 year old male diabetic presented with active Charcot occurring in the right ankle (10 years ago, he had Charcot in his midfoot). He does not do a lot of walking. I gave him the following choices for off-loading: Crow walker with Roll-About, Ex-fix (some surgeons will do during the 1st stage), and wheelchair. He didn't like any of the choices. My question is, can a patient weight-bear if he is in a TCC with the first stage of Charcot in the ankle?
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| QUERIES (MEDICAL-LEGAL) | |
Query: Locum Tenens and State Licensing
Under locum tenens, can a doctor who is licensed in a one state work in another state that he is not licensed in?
Charles Morelli, DPM, Mamaroneck, NY
Editor's comment: PM News does not provide legal advice. Although federal law (locum tenens) generally trumps state law, licensing is a privilege granted to states. Thus, a podiatrist must be licensed in the state in which s/he will be acting as a locum tenens.
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Podiatric Foot & Ankle Surgeon - Massachusetts
The Division of Podiatric Surgery at Beth Israel Deaconess Medical Center and Harvard Medical School are recruiting a podiatric foot and ankle surgeon to work in a multi-specialty, hospital-based group. Minimum requirements include completion of a residency in an accredited three-year podiatric surgical residency program and experience in hindfoot reconstructive surgery. Academic appointment at Harvard Medical School at the rank of Instructor or Assistant Professor will be commensurate with experience, training, and achievement in the field. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Women and minorities are particularly encouraged to apply. Letters of application or nomination should be sent, together with a CV to: Eileen Rose, Administrative Director erose@bidmc.harvard.edu
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| CODINGLINE CORNER | |
Query: Neuritis ICD-10 Codes
Is there a specific diagnosis code for neuritis or nerve impingement of the:
A. medial dorsal cutaneous nerve?
B. intermedial dorsal cutaneous nerve?
C. lateral dorsal cutaneous nerve?
Gary Unsdorfer, DPM, Medina, OH
Response: The named nerves you listed do not have their own specific diagnosis codes.
For neuritis, you would look at several options:
1a) G57.80 (other specified mononeuropathies of unspecified lower limb)
1b) G57.81 (other specified mononeuropathies of right lower limb) or
2) M79.2 (neuralgia and neuritis, unspecified; Excludes 1: lumbosacral radiculitis NOS (M54.1) mononeuropathies (G56-G58)
David J. Freedman, DPM, CPC, Silver Spring, MD
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| RESPONSES/COMMENTS (ICD-10) | |
RE: Lack of ICD-10 Crossovers
From: Jeffrey Kass, DPM
Since the implementation of ICD-10, it has become obvious to us all that there are many ICD-9 codes that have no ICD-10 crossovers. Furthermore, many of the ICD-10 codes are "unspecified", which is counterproductive to the aim of being more specific, which was supposed to be part of the rationale behind ICD-10. I assume that there is some committee somewhere that is collecting these codes to forward to the people who facilitate new codes. Who are both sets of people? Who are the podiatrists tasked with this?
I was hoping to find some sort of chart or table on the APMA website to ensure codes I come across are listed, but did not find one. We are collectively making one, correct?
Jeffrey Kass, DPM, Forest Hills, NY
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| RESPONSES/COMMENTS (YOU CAN'T MAKE THESE THINGS UP) - PART 1 | |
From: George Jacobson, DPM
I find these codes amusing and look each up to verify that they exist. They do! Eventually, we could be denied payment for incomplete or incorrect coding. Can you imagine being denied payment for a open wound of a right great toe (S91.101X) because you left out Y92.253 (Opera house as the place of occurrence of the external cause)? Let's remember that the PQRS has not demonstrated that the data collected has been used in a meaningful way to improve quality of anything. Yet based on a PM News survey, it will decrease payment to 82% of us.
I predict that eventually ICD-10 will cause us enumerable denials, leading to reviews and appeals costing physicians further declines in income. You can never convince me that these changes have anything to do with improving the health and welfare of our patients. Instead they are only are road blocks to physician reimbursement. In case you haven't noticed, there have been no such impediments to the pharmaceutical companies. Physicians are at the bottom of the reimbursement totem pole and are the main group that keeps getting cut.
George Jacobson, DPM, Hollywood, FL
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| RESPONSES/COMMENTS (YOU CAN'T MAKE THESE THINGS UP) PART 2 | |
From: Brandon Macy, DPM
I read that Y92.253 is an ICD-10 code for “hurt at the opera.” If combined with G54.6 (phantom limb pain), would that refer to an injury sustained at Phantom of the Opera?
Brandon Macy, DPM, Clark, NJ
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous New ICD-10 Code of the Day
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| Now, even staying home is dangerous! |
Source: Keith L. Martin, Medical Economics
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MEETING NOTICES
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| CLASSIFIED ADS - PART 1 - ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION – SOUTHERN CALIFORNIA
Full-time associate leading to partnership. Immediate position available. Busy office with multiple locations. Full scope practice. Three year residency preferred. ABPS Board qualified/certified. California license required. Benefits included. Inland Empire. Please forward resume tofamilyfootcenter@verizon.net
ASSOCIATE POSITION - NEW JERSEY
Well established Podiatry practice in NJ is looking for hardworking and very energetic Full-time podiatrist to do House-calls In Nothern part of NJ. Salary 100k plus Bonuses. Must have NJ Podiatry license and NJ Medicare number. Full-time position available starting immediately. Please email your resume to lraginsky@gmail.com
ASSOCIATE TO PARTNERSHIP POSITION – SOUTH FLORIDA
Rapidly growing, cutting edge south Florida practice seeks well rounded, personable, hard-working surgical podiatrist for immediate start and for July 2016. Practice is involved in all aspects of podiatry, foot and ankle surgery and resident training. Clear, successful model for partnership with competitive salary, incentive and benefits..please send CV and cover letter to kkinmon@gmail.com
ASSOCIATE POSITION – MARYLAND, DC SUBURBS
Large, well established, multi-office practice looking for an Associate to begin July 2016. Looking for a highly motivated, surgically trained, outgoing, ethical Podiatrist to join us. Walk in day one with a full schedule. Must be at least Board Qualified by start date with Maryland license. Competitive compensation package with excellent base salary, bonus structure, benefits, and partnership opportunity. Well rounded Practice that covers all aspects of Podiatry. Cover Letter and CV to Sharon at MarylandPodiatry@yahoo.com.
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Experienced support staff, great benefits including malpractice coverage. Excellent opportunity for a promising future. To apply, go to www.yourcareerinpodiatry.com
ASSOCIATE POSITION - BANGOR, MAINE
Seeking personable, well rounded individual to join our well established, modern three-doctor practice performing all aspects of foot and ankle care. Digital x-ray, EHR, DME, etc. Competitive salary with bonus structure and benefits. Early partnership opportunity for the right person. Send letter of interest and CV to: Mainoffice@acadiafootandankle.com
ASSOCIATE WANTED - SOUTHWEST, FL
Associate position: now or July '16: must be BC or BQ by ABFAS, ability to work independently on complex cases. Hospital rounds, ER calls, great work ethic, team players needed. Fellowship experience preferred, not mandatory. LOI, LOR from director, CV. great salary + bonus, partnership buy-in. Naples, FL klamdpm@hotmail.com
ASSOCIATE POSITION - LOWER HUDSON VALLEY, NY
Multiple locations. 50 minutes from NYC. PMSR RRA. Surgical practice, strong surgical volume. Must be willing to perform all phases of Podiatry. New graduates or experienced practitioners. Salary 110k-120k plus bonus. Please email letter of intent, CV and surgical logs to podiatrypractice@yahoo.com
ASSOCIATE POSITION - NASSAU COUNTY
Full-time/Part-time associate needed for busy Long Island practice with EHR, digital x-rays and DME. Excellent income opportunity for hard working energetic podiatrist. ABPS board qualified/certified preferable. Must be versed in all aspects of podiatry surgical/medical/orthoped and able to work independently. Send resume: jbmbcw@yahoo.com
ASSOCIATE POSITION - CONNECTICUT
High volume practice seeking a hard working, motivated, Connecticut licensed podiatrist. Duties to include diabetic foot care, wound care, and minor office procedures, nursing homes, and house calls. Please submit CV to: podiatrypeople@gmail.com
ASSOCIATE POSITION - LOUISVILLE, KENTUCKY
available immediately in a busy, 30 year established, single location, high visibility office with digital x-ray, DME, diabetic shoe store, and EMR. Good patient volume and potential for partnership or purchase. Contact samuel10530@yahoo.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@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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| CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PART TIME OFFICE SPACE AVAILABLE - LODI, NJ
Podiatry office space available for use more than half the week in Lodi, NJ. 2 fully stocked treatment rooms, digital x-ray and EHR available. Perfect for someone looking to expand their practice into the Northern NJ area in Bergen County, or just starting out. Currently only seeing patients on Mondays and Thursdays. If interested please email lodipodiatrist@gmail.com
PRACTICE FOR SALE- SOUTHEAST FLORIDA
Busy well established successful turn-key Podiatry practice for sale. Active adult community. Professionally designed and decorated. Office is immaculate. Good yearly gross with many new patients. Medicare and cash patients. No managed care. Owner willing to stay for transition. Excellent well trained staff. Click on link to view website. www.turnkey-podiatry.com
PRACTICE FOR SALE - SUFFOLK, LONG ISLAND, NY
Well established, 30 year Multilocation (will separate) in Smithtown & Medford LI, NY. Doctor retiring. Grossing $970,000 ($650,000; $320,000). Both locations newly renovated: full operatories, all new MTI chairs, Full Zimmer Micro surgical set, Yag PINPOINTE laser (fungus TNs) and CO2 laser. Excellent dedicated staff. Low overhead. wjbpod@aol.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@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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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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