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12/13/2021
QUERIES
Query: Medicare Part “D” Approved Antifungal Creams
I am curious what others are prescribing as topical antifungal creams that are covered by Medicare Part “D” or supplemental plans. Personally, I got so tired of filling out medical necessity forms that were ultimately denied anyway that I am currently prescribing ketoconazole, ciclopirox, olamine, or nystatin.
The challenge that I have is these are rarely listed as medications of choice by the clinical laboratories, yet those are either OTC (e.g., terbinafine, tolnaftate, etc.) or routinely denied when prescribed.
Richard A. Simmons, DPM, Rockledge, FL
Other messages in this thread:
03/30/2026
QUERIES (NON-CLINICAL)
Query: Repair of Old Midmark Chair
Does anyone have a recommendation to repair a Midmark 417 chair? It just stopped working but the chair has power. Midmark won’t repair it stating that it’s too old. It was fine one day and the next no movement at all. I thought maybe the foot controls went bad so I bought a hand controller and still nothing. The outlets on the chair have power so I know it’s not the primary plug in the wall.
David Krausse, DPM, Flemington, NJ
03/17/2026
QUERIES (NON-CLINICAL)
Query: Who's Performing the Procedure?
One of my patients told me that she is scheduled for her first diagnostic colonoscopy this coming summer. She specifically chose a doctor who is well reviewed, and the procedure will be done at a teaching hospital. She is concerned that since she will be under anesthesia, she will not know if the person doing the procedure will be the doctor she is hiring, or a PA, nurse practitioner, or even a GI resident. How can this patient or any patient ensure that a procedure will be done by a physician and not a PA,, NP, or GI fellow doing it for the first time?
Elliot Udell, DPM, Hicksville, NY
03/13/2026
QUERIES (CLINICAL)
Query: Bleomycin Injections for Verrucae
Is anyone using bleomycin injections for verrucae? What is your protocol and success rate?
Brian Kiel, DPM, Memphis, TN
03/09/2026
QUERIES (MEDICAL-LEGAL)
Query: Why does an insurance company require high limits of liability for providers who are being credentialed?
From: Joseph Borreggine, DPM
Recently, I have come across information indicating that health insurance companies may mandate providers on their panel care high liability limits regarding malpractice insurance. Certain companies based on geographic area or nationally are requiring a $1 million to $3 million liability limit to even consider credentialing a physician. I am uncertain whether this requirement applies universally or is specific to certain insurance companies. However, I find this development intriguing, as there are many podiatrists who do not participate in surgery and primarily just practice general podiatry.
This situation is appropriate regarding podiatrists who are foot/ankle surgeons, but I am confident that there are many of us who continue to practice general podiatry without performing surgery for various reasons. This limits access to a number of qualified experienced providers with certain carriers who do not carry these high limits of liability on their policy. Additionally, I am also curious to see if this has affected any of my colleagues and prevented them from being credentialed?
A search on the Internet yielded the following response to my query regarding obtaining high liability limits: “Credentialing organizations often mandate higher liability limits to ensure that healthcare providers can cover potential claims. This requirement helps maintain a standard of care and protects both the provider and the institution.”
Joseph Borreggine, DPM, Fort Myers, FL
02/20/2026
QUERIES (CODING AND BILLING)
Query: Podiatry Billing Company Recommendations
I’m a solo practitioner looking for a new billing company, preferably one with strong podiatry experience. A relentless effort in fighting denials is crucial. Solid customer service and communication are also key. Any recommendations?
Chris Seuferling, DPM, Portland, OR
01/20/2026
QUERIES (NON-CLINICAL)
Query: American Association of Surgical Foot Specialists
While going through some of my father's papers, I stumbled across several correspondences regarding the American Association of Surgical Foot Specialists ranging from the 1950s to 1970s. This is NOT the American Ambulatory Foot Surgeons group. I'm curious if it's still around somewhere. Would there be any interest in creating an online documentary repository?
H. David Gottlieb, DPM, Baltimore, MD
01/14/2026
QUERIES (NON-CLINICAL)
Query: AI Scribe Systems
What AI scribe system have other podiatrists set up? How much does it cost and how private is it?
Daniel Chaskin, DPM, Ridgewood, NY
01/12/2026
QUERIES (MEDICAL-LEGAL)
RE: HIPAA and Credit Cards
From: Daniel Chaskin, DPM
Does HIPAA allow a podiatrist to mandate a future or current patient give their credit card information for a podiatrist to keep so that patients can be charged for missed appointments, co-payments, and deductibles?
Daniel Chaskin, DPM, Ridgewood, NY
Editor’s Comment: PM News does not provide legal advice. HIPAA generally allows podiatrists and other healthcare providers to require a credit card on file for future charges, as long as the information is handled securely. However, New York State law (where you are currently located) significantly restricts this practice.
• Patient's medical identity must still be protected under HIPAA Privacy and Security Rules.
• Authorization: Providers must obtain clear, written consent from the patient that explicitly details when and how the card will be charged (e.g., for no-shows or after insurance has paid its portion).
New York Specific Restrictions
In New York, recent legislation (General Business Law § 519-A and Public Health Law § 18-c) provides much stricter...
Editor’s Note: This extended-length letter can be read here.
01/10/2026
QUERIES (CREDENTIALING BOARDS)
Query: CMS Withdraws BOC’s Status as an Accrediting Organization (AO)
We recently received notification of the Board of Certification/Accreditation (BOC) no longer being an approved accrediting organization by CMS. I completed my re-credentialling with BOC in 2025 prior to the December 2nd announcement. I have two questions.
First, BOC has filed a lawsuit against CMS for this ruling. Should I proceed with credentialling with another organization, or wait for the outcome of the lawsuit? The CMS website says to re-credential immediately, but this is a large and expensive task.
Second, for those using another organization for their credentialling, are you happy with them? I found ABC difficult to work with in the past, which prompted my switch to BOC more than 10 years ago.
Michaele A Crawford, DPM, Butler, PA
01/07/2026
QUERIES (MEDICAL LEGAL)
Query: Nail Biopsy Results – Candida Parapsilosis
We received nail biopsy reports these days that are filled with information and treatment recommendations. From a medical-legal point of view, what should be done in the following scenario. A healthy 35-year-old female's nail PCR report indicates: "isolation of Candida parapsilosis. This should always suggest careful evaluation of the patient, as Candida onychomycosis is frequently associated with diabetes or immunodepression."
This patient is not a diabetic. This patient has no systemic symptoms that would indicate immunodepression. Is there anything else to do to protect oneself?
Name Withheld
12/30/2025
QUERIES (NON-CLINICAL)
RE: Should We Dispense Products from Our Office?
From: Elliot Udell, DPM
At board meetings of the American Society of Podiatric Medicine, a specialty group dating back to the 1940s, there was constant arguing and finger-pointing at doctors who sold products from their offices. All of the board members were in podiatric academia. The argument against dispensing is that most doctors from all facets of medicine and dentistry do not sell products to their patients; I was the black sheep in the room.
Recently, I went to a new dental office for a cleaning. After cleaning my teeth and gums, the hygienist asked if I was using an electric toothbrush. I told her that mine broke six months ago and I never replaced it. She was quick on the draw and let me know that the office sells them to patients and I bought one for fifty dollars. I was happy for the service and do not think any less of any of the dentists or hygienists.
Elliot Udell, DPM, Hicksville, NY
12/18/2025
QUERIES (NON-CLINICAL)
Query: Alternative to Cantharidin
Our Canadian supplier of Cantharidin is no longer servicing the U.S. Does anyone have an alternative?
Dieter Fellner, DPM, NY, NY
12/16/2025
QUERIES (MEDICAL-LEGAL)
Query: Duty to Report Changed Status When Employed by Practice Buyer
I recently sold my practice and I am now working for the purchaser who has a different NPI and Tax ID.
1) Do I have to notify the various insurance companies of the sale or is the fact that I won't be submitting claims any longer under my NPI/Tax ID sufficient?
2) I have to download the Electronic Remittance Advice (ERAs) from my EMR vendor. How many years of ERAs should I save?
Name Withheld
12/15/2025
QUERIES (NON-CLINICAL)
Query: Source for Jan-L Repairs
Jan-L is out of business. Does anyone have a guy who repairs these anywhere? I’m not looking for a new unit, but when it needs repairs, I'd like to have someone to fix it.
David Luongo, DPM, Paramus, NJ
Editor’s comment: RAM Products (732) 651-5500 now sells and services Jan-L products.
12/15/2025
QUERIES (EHRs)
Query: AthenaOne EHR and Billing
Is anyone using AthenaOne EHR and billing? I would really appreciate any opinions from my DPM colleagues.
Dawn Buratti, DPM, Tarzana, CA
12/09/2025
QUERIES (MEDICAL-LEGAL)
Query: Uploading Patients’ Charts into AI
Is it okay to upload patient chart info to Chat GPT if the name of the patient is removed? For example, if a podiatrist had a dermatoscopic image to upload or a chart to upload with the patient’s name redacted, can a podiatrist use a local language model on your local computer or Chat GPT? How does a podiatrist comply with HIPAA regarding this choice?
Daniel Chaskin, DPM, Ridgewood, NY
Editor’s comment: PM News does not provide legal advice. To best understand what is considered Protected Health Information (PHI) under HIPAA, it is necessary to review not only the definition of Protected Health Information under HIPAA in 45 CFR §160.103, but also the definitions of “health information”, “individually identifiable health information”, and “designated record set”.
Source: The HIPAA Journal
11/17/2025
QUERIES (MEDICAL-LEGAL)
Query: Insurance Request for Chart Notes
Recently, I received an email from Regence requesting 16 patient chart notes free of charge. I’m familiar with receiving similar requests from third-party vendors (ex. CIOX, Change Healthcare, etc.) and have successfully charged them for chart note access. However, this one reads differently to me, as it is directly from Regence demanding that I send chart notes to CIOX. They pull contract language as noted and state I am obligated to do so at no cost to them. Am I obligated or do I stand my ground and still demand payment? Have others experienced similar situations and what was the end result?
Medico-legal speaking, I will abide by what’s right, but it makes me wonder that if Regence is correct (i.e., I am under contract), then why have other insurances/vendors paid us physicians thousands of dollars for chart notes when they could have simply and legally enforced the same language Regence did? I imagine most, if not all, insurance contracts have similar language as Regence’s. Or is this just a game of calling each other’s bluff?
Chris Seuferling, DPM, Portland, OR
11/12/2025
QUERIES (NON-CLINICAL)
Query: Source for PDM Podiatry Chair Repair
Is there a highly recommended repair person to repair a PDM Chair in the Long Island area?
Dennis Fassman, DPM, Westbury, NY
11/10/2025
QUERIES (NON-CLINICAL)
Query: Compounding Pharmacy for Cantharone
Can anyone suggest a 503b compounding pharmacy that we can order Cantharone from?
Ed dos Remedios, Providence, RI
11/08/2025
QUERIES (NON-CLINICAL)
Query: Source for Dremel 3000 Nail Grinder
We bought this nail grinder somewhere almost 10 years ago. It’s a great grinder; the main benefits are the large dust intake and very flexible hose, as well as the affordability of the system, as the only custom part is the Dremel attachment and the air hose.
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Dremel 3000 Nail Grinder |
I’ve searched for hours and can’t find another one. Can anybody help me source another couple of these?
Daniel Jones, DPM, Casper, WY
11/06/2025
QUERIES (NON-CLINICAL)
Query: Unequal Salaries
Can someone explain to me why the ACFAS career center website is mostly populated with ads from employers seeking MD/DO only positions? Do you think you will EVER see a DPM employer being able to post an ad on the AOFAS career center website? And then look at the salaries being offering compared to the ones being offered by DPM employers? Is anyone awake at the wheel?
Chad Rappaport, DPM, Westwood, NJ
10/24/2025
QUERIES (NON-CLINICAL)
Query: RVU Conversion Rates for Employed DPMs
I’m trying to gather information on conversion rates for RVUs In NFP Health systems. First: Straight conversions vs. straight with decreased rates for bonuses. Second: conversion rates relative to orthopedics in the same system. Third: is anyone aware of potential avenues podiatry could take regarding potential discrimination in this situation?
Tim Vogler, DPM, Winston Salem, NC
09/25/2025
QUERIES (NON-CLINICAL)
Query: Alternative to the Gordabalm Lotion?
Does anyone have an alternative to the Gordabalm Lotion since the company went out of business?
Tom Debenedictis, DPM, Union City, NJ
09/23/2025
QUERIES (NON-CLINICAL)
Query: DEA MATE Training
I am in the process of renewing my DEA license. I noticed it only allows for courses that are accredited by AMA, even dentistry, but I see no podiatry accreditation courses. Is this correct?
Gary Friedlander DPM, Phoenix, AZ
09/13/2025
QUERIES (NON-CLINICAL)
Query: Sources for Spenco Products
Does anyone have any sources for Spenco products?
A James Fisher, DPM, Eureka, CA
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