The Voice of Podiatrists

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December 14, 2006 #2,765 Editor-Barry Block, DPM, JD

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PA Podiatrist Offers Foot Care Products and Advice Through Website

When people are moved past simply dreaming of relief from foot pain, discomfort or other special needs to seek out the services of a specialist like board-certified podiatrist Dr. Maasi J. Smith, they discover a foot care product line and foot care system developed by Smith with reliable, proven ingredients - offering a safe alternative to prescription-based medications. Designed to deeply cleanse, exfoliate, soothe and tone feet by using natural ingredients, at www.MyBadFeet.com, Dr. Smith's Foot Care focuses on good foot health along with relaxation and rejuvenation.

Dr. Maasi J. Smith

Dr. Smith, a graduate of Temple University School of Podiatric Medicine, completed his residency training in Philadelphia, and practices in the prestigious Rittenhouse Square section of Philadelphia. "MyBadFeet.com offers expert foot care information and education," said Smith. "I truly care about people and enjoy my profession - I want everyone to feel comfortable about taking appropriate care of their feet."

Source: EWorldwire [12/12/06]

PA Podiatrists Help Flyers Captain

Captain Peter Forsberg met with Temple University podiatric physicians Kendrick Whitney and Sandy Dalton along with orthotic specialist R. Dennis Higman, and the three devised a skate boot to stabilize Forsberg's right foot. Forsberg has been plagued by skate problems on his foot after undergoing ankle surgery in the off-season. The boot is expected to be manufactured this week.

Dr. Kendrick Whitney

"They cut the skate boot up top and down to the mid-foot, so when he tightens the skate it locks his foot in," McCrossin explained. "Before, when he would tighten it, his [ankle would roll]. We're also going to go with a bigger skate to allow his foot to sit down deeper into the boot. "They also gave him a custom orthotic to go with it, not a radical orthotic, but a simple one that they can play with a little bit. Peter feels very comfortable with what's going on and sees a light at the end of the tunnel."

Source: Tim Panaccio, Philadelphia Inquirer [12/12/06]

TX Podiatrist Sentenced To Prison For Tax Evasion

A Gassville, TX man who worked as a podiatrist in Mountain Home was sentenced Tuesday to two years in prison and was ordered to pay about $300,000 in restitution to the Internal Revenue Service. Clifford B. Marston, 57, was sentenced by Judge Jimm Larry Hendren in U.S. District Court, Western District of Arkansas, after being convicted in May of tax evasion and filing false income tax returns. In June 2005, Marston was named in a 25-count indictment charging him with income tax evasion, filing false income tax returns and assisting in the preparation and presentation of false individual income tax returns to the IRS.

During the trial, the prosecution proved Marston illegally stopped withholding employment taxes from his employees' salaries in 1999, and was filing false employment tax returns with the IRS from 1999 to 2001, claiming no federal wages were paid to employees, according to the news release. After 2001, Marston stopped filing employment tax returns and personal income tax returns. Marston also was convicted of income tax evasion for personal tax returns from 1998-2000.

Source: Joanne Bratton, Baxter Bulletin [12/13/06]

MI Legislature Passes Resolution for Title XIX Podiatric Physician Definition

On 12/12/2006 the Michigan legislature adopted House Resolution 0248, A resolution to memorialize the Congress of the United States to enact legislation to amend the definition of "physician" in the Medicaid program to include podiatric physicians.

Source: Michigan Legislature Website

Query: Coding Toe Fillers for Shoes

I have a non-diabetic patient with bilateral non-traumatic forefoot amputations who needs toe fillers made. He has Medicare as his primary insurance.

Is this a covered benefit for Medicare, and how is it coded?

Jeffrey H. Katz, DPM, Anaheim Hills, CA

Response: Medicare covers L5000, "longitudinal arch support with partial foot filler" when a significant portion of the foot has been lost, and use of the filler will help to prevent further deformation and/or fascilitate gait. The basis for need is not diabetes-related.

Each foot is addressed separately. In this case, the devices should be billed with an "LT-RT" modifier, and a quantity of 2.

As with all Medicare DME items, the chart should contain explanation of therapeuitc necessitiy for the devices, the patient should sign a "Certificate of Receipt," be given a copy of the 21 supplier standards, and dispensing chart notes should indicate that they patient was given instructions for use, and was happy with the fit and function of the device(s).

Josh White, DPM, CPed, New York, NY

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

RE: Alleged Misdiagnosis - Cancer Wrongful Death
From: Elliot Udell, DPM

I am by no means happy that a patient died from an undiagnosed lesion but I am glad that we have an opportunity to discuss something that has been bothering me for a long time.

If we see a lesion that clinically appears like a ganglion cyst or plantar fibromatosis, should we rely on clinical judgment, aided by the latest imaging studies or should we start taking invasive biopsies of every deep lesion we see, possibly causing other forms of morbidity? I know fine doctors in both the podiatric and orthopedic worlds who advocate biopsy for all lesions. I know others that don't. As for imaging studies, they too are not always conclusive.

I had one case of a suspicious lesion on the patient’s hallux. I took radiographs, ultimately ordered sonograms, an MRI, and at the behest of the radiologist, even a CAT scan. The radiologists told me they did not know what the lesion was, but thought it was benign, but could not swear it was not malignant. To our chagrin ultimately a sliver of glass surfaced. No radiological study identified the small foreign body and each study was conducted by well-trained radiologist. A lack of recollection of trauma entered in the mix. Had I done a wide excision, it is possible the lesion would not have healed well and the patient might have needed a graft. Maybe he would have had a permanent scar to worry about. Time eventually revealed the true diagnosis but I could very well have erred and I could have been the doctor being called on the carpet for missing an awful diagnosis.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Schwannoma (Art Hatfield, DPM)
From: Carol Callahan, DPM

I resected this lesion which emanated from medial dorsal cutaneous nerve from my patient a few weeks ago. We had anticipated a ganglionic cyst, however, clearly this lesion is a neurilemmoma, which is comprised of Schwann cells and often referred to as a Schwannoma. The lesion was well encapsulated and had the same consistency of an intermetatarsal neuroma.

Schwannoma

Carol Callahan, DPM, Fairfield, CT, ccallahan@advancedmedicalfootcare.com

ASSOCIATE POSITION - CINCINNATI, OHIO

One of the largest podiatry practices in the United States is again in need of a PSR 24-36 Associate. All present doctors are in their thirties with similar training. Everyone is treated equally and there is definitely no limit to your success. Please submit resume or contact Karen Roesch via email or phone. Kroesch4poh@aol.com (513) 729-4455

ASSOCIATE POSITION- MEMPHIS, TN

30 year-old, high volume, multi-office practice in Memphis, looking for 24-36 PSR trained individual. Good opportunity for reconstructive surgery and wound care. No nursing homes or weekends. Potential partnership opportunity. Contact Footdok4@gmail.com

ASSOCIATE POSITION/ MANHATTAN AND LONG ISLAND

Seeking well trained podiatrist to help expand existing surgical practices. Candidate must be able to acquire staff privileges. Package and terms are negotiable, flexible hours. Email PODO2345@AOL.COM OR CALL (516) 476-1815

EQUIPMENT WANTED – USED X-CELL X-RAY UNIT

Used X-cell midbase Podiatry X-ray unit with orthoposer, Expected price. $3000.00 Mark Robson, DPM, Austin TX. 512 585-0242 mrobsondpm@aol.com

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE POSITION - LOS ANGELES/SOUTH BAY AREA

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227.

PRACTICE FOR SALE – NEW YORK

20 Year practice by-the-sea in beautiful Long Beach, NY. Excellent Terms. E-mail seashell554@aol.com or (516) 432-7300.

ASSOCIATE POSITION – NEW YORK CITY

Looking for an enthusiastic well-trained foot and ankle surgeon to join busy Manhattan/Brooklyn practice leading to partnership. Candidate must have completed a minimum two-year surgical residency program, demonstrate qualities of self-motivation and have impeccable skills in forefoot and rearfoot surgery. Package includes malpractice ins. health ins. plus salary. Terms negotiable. Email Manfootcare@aol.com or call 917-756-3686

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