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PM News

The Voice of Podiatrists

Serving Over 16,962 Podiatrists Daily


March 28, 2015 # 5,333 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

officiteasst


PM NEWS QUICK POLL

FINAL DAY TO VOTE

Quick Poll

Will the latest proposed Sustainable Growth Rate "Doc Fix" Bill pass?

Gordon10


CENTRAL


AT THE COLLEGES
CSPMSM and AAWP Clubs Volunteer at the Napa Valley Marathon
 
CSPM Club students with Drs. Timothy Dutra and Sky Shanks at the  Napa Valley Marathon.
 
On March 1st the California School of Podiatric Medicine Sports Medicine (CSPMSM) and American Association of Women’s Podiatrists (AAWP clubs teamed up to provide podiatry first aid at the Napa Valley Marathon. A group of 17 students were led by Drs. Timothy Dutra, and Sky Shanks served at both the finish line medical tent and at the various aid stations along the course. It was a great experience that allowed the students to see and treat injuries unique to endurance athletes.
 
Source: Sarah Feddersen

Dr. Remedy


PODIATRISTS IN THE COMMUNITY

NJ Podiatrists Celebrate National Doctor's Day

March 30 is officially recognized as National Doctor’s Day.  It was signed into law in 1990 by President George Bush as a way to recognize physicians, the work that they do, and the contributions that they make to society. 
 
(L-R) Drs. Maryellen Brucato, Daniel Margolin, and Daniel Hennessy
 
New Jersey Foot and Ankle Center in Oradell is celebrating this holiday by commending their team of podiatric physicians, including owner Dr. Daniel Margolin and associates Drs. Maryellen Brucato and Daniel Hennessy. All three doctors at the center specialize in medical and surgical foot care. In honor of National Doctor’s Day, they signed a service policy declaring that they will always deliver on what they promise.

cuttingfeb15


HEALTHCARE LEGISLATION
House Votes for Permanent Doc Fix, Bill Goes to Senate
 
The U.S. House Thursday voted overwhelmingly 392-37 in favor of scrapping Medicare's sustainable growth-rate formula, passing a permanent doc fix. The measure next goes to the Senate for a vote. President Barack Obama has indicated he will sign the measure. The Senate still needs to pass the bill before adjourning on Friday. Senate Democrats have raised concerns about abortion language in the legislation and only extending the Children's Health Insurance Program for two years, but those reservations have faded as the repeal package has gained momentum. If enacted it would end a cycle of short-term doc fixes that has persisted for more than a decade.
 
The legislation gives physicians an annual 0.5% bump for the next four years. Payment rates would then hold flat for six years. Then most doctors would see annual 0.25% payment increases. The bill also sets up a two-tier payment system that provides incentives for doctors to shift more of their practice into value-based payment models, including accountable care organizations, bundled-payment arrangements, and medical homes.
 
Source: John N. Frank, Adam Rubenfire, and Paul Demko, Modern Healthcare [3/26/15]

aetrex3


PRACTICE MANAGEMENT TIP OF OF THE DAY
Avoid Modifier 79 Abuse
 
When Modifier 79 was established, it provided a simplified way to bill for services pthat were unrelated to the original surgical procedure during the post-operative period. Unfortunately, Modifier 79 has been prone to abuse. The Office of Inspector General "initiated an investigation after receiving allegations that a provider was billing for podiatry surgeries that were never performed. The investigation substantiated the allegations and revealed that the provider billed for surgeries for his patients every five to six days."
 
To avoid detection, nearly every time the provider billed for surgery, the Modifier 79 was used. He received payment on many of these surgeries because Medicare has a front-end edit on Modifier 79 that allows the claim to be processed without review. When the physician was audited, it was found that "the provider's abuse of the Modifier 79 enabled him to defraud the Medicare program of a significant amount of dollars between 1994 through 2000." (CMS Pub 100-20 Transmittal 442 CR 6334)
 
Source: Nancy Clark, Advance Healthcare Network

milehigh


CODINGLINE CORNER
Query: No PCP with High Risk Foot Care Patient
 
A doctor in our office recently evaluated and treated a patient at an assisted living facility for high risk foot care. The patient qualified for palliative services with absent pedal pulses and pain. The patient reported not having a primary care provider and has not seen one in over 3 years. I believe that we are required to indicate an active treatment plan to Medicare (by submitting last date of visit to a primary care physician) when treating for high risk foot care. Is this correct? How would we handle this case, as the patient has not been treated for such a long period of time and states that he is not under a primary care provider's care? 
 
Daniel C Albertson, APRN; President, Office of Paul Krestik, DPM,  London, KY
 
Response: Most routine foot care LCDs require that you submit the date the patient was last seen, NPI number, and the name of the MD/DO managing the patient's systemic condition, IF the qualifying diagnosis has an asterisk (*) next to it. Peripheral vascular disease conditions, with few exceptions, have no asterisk designation. I don't think you have to worry about it in the case you describe. 
 
Jeffrey Lehrman, DPM, Springfield, PA
 
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

Diafoot


RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
RE: Failed 1st MPJ Fusion
From: John J. Doolan, DPM, Jeffrey Kass, DPM
 
I recommend a revision fusion, with rigid fixation such as a plate and screws; it will address your concerns. I also recommend a bone stimulator post-surgery and consider use of a bone narrow aspirate concentrate (BMAC) at the time of fusion. Of course, non-weight-bear post-op appropriately. 
 
John J. Doolan, DPM, NY, NY
 
I think you should seriously consider a Keller for a 72 year old male.
 
Jeffrey Kass, DPM, Forest Hills, NY

Blaine8


RESPONSES/COMMENTS (CLINICAL) - PART 1B
RE: Failed 1st MPJ Fusion
From: Barry Mullen, DPM
 
We know nothing about the activity level of this 72 year old male. That said, given 2 prior surgeries on the 1st MTP, coupled with an incomplete pan met head resection (which makes little sense to me), I'd incorporate the KISS approach. First, forego a 4th metatarsal oseotomy in lieu of a 4th metatarsal head resection. This will complete the pan met head resection and likely eliminate the sub 4 symptom. 
 
As for the 1st MTP, why is there any pressing need to realign the IM angle? There's no mention of medial 1st metatarsal pain, only plantar symptoms. After 2 failed surgeries and an impending 3rd, I'd be concerned about...
 
Editor's note: Dr. Mullen's extended-length letter can be read here.

realm


RESPONSES/COMMENTS (CLINICAL) - PART 1C
RE: Failed 1st MPJ Fusion
From: Peter J. Bregman, DPM
 
It depends on the ambulatory status of the patient as well as his bone stock and the reason the non-union occurred. Without knowing all of this, I recommend either trying to fuse the joint again using allograft from the calcaneus along with amniotic tissue graft and a different type of fixation (probably plate and screws), or utilizing a silicone double stemmed implant with grommets.  If you don't have enough length after the fusion, you can always do a distraction Calais procedure to gain proper length. If you are not adept with external fixation, find someone who is.
 
Peter J. Bregman, DPM, Las Vegas, NV

AAPPM


RESPONSES/COMMENTS (NON-CLINICAL)
RE: Accepting What Medicare Pays
From: Joseph Borreggine, DPM
 
I have started seeing Medicare patients in assisted living centers for foot care. After Medicare pays for the services rendered and per CMS policy guidelines, I have been balance billing those residents who had not met their annual Medicare deductible, or their co-insurance did not cover the deductible. 
 
After the bills were sent and received, I received phone calls from certain residents who stated that they did not want to be seen anymore. The reason was because...
 
Editor's note: Dr. Borreggine's extended-length letter can be read here.

safestep


RESPONSES/COMMENTS (PM NEWS QUICK POLLS)

In a recent PM News Quick Poll, 80% of 815 respondents reported that they performed less than 10 surgeries a month. Some letters to the editor posited that this was a function of competence of surgeons (surgical trained vs. non-surgical), breakdown of difficulty of procedures, scope of practice, etc. My experience tells me that the decrease in elective podiatric surgeries is a function of insurance company requirements and regulations. In the past, we received 80% of what we charged; today we receive 20%.

With high deductibles, pre-certification, authorization black holes, and overhead increases of running a practice (unless you are working for a hospital corporation), the numbers are naturally down, and not just for podiatric cases. Look at the your OR surgical schedules on the posting boards in your surgical centers for proof.

David S. Wolf, DPM. Houston, TX

MSI


YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Shoe of the Day

Are these legal for the women's NCAA Tournament?

Source: fanpop

MEETING NOTICES

SBW

western


cap


aafas8


CLASSIFIED ADS
PODIATRY EQUIPMENT FOR SALE
 
Neurogenx 4000 Pro with electrodes and leads (8,000 obo). Cryo-Pac MCU001US/Cryomed Device, Includes Console, power cord, Foot switch, 2 probes and hose (1,200 obo).  Summit Doppler - Vista AVS Vascular Doppler, comes on a rolling stand with all attachments, Installation and training CD (2,500 obo). Please email me dapodman1@yahoo.com 
 
PRACTICE FOR SALE - NEW YORK METRO AREA 
 
30 year old diversified practice fully equipped. High Gross High net . revenue reliable staff low overhead good leases  Dr. will stay on as long as requested  to assure  smooth transition great opportunity for podiatrist surgeon.  Email rrranch7@yahoo.com 
 
PRACTICE FOR SALE - SOUTHWEST FL
 
Multilocation (will separate) multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com
 
PRACTICE FOR SALE – CALIFORNIA 
 
Well established podiatry practice for sale in the beautiful central coast of California.  We are a comprehensive, state-of-the-art practice that includes surgical, palliative, wound care, and sports medicine opportunities.  Five fully equipped treatment rooms with advanced technologies: EMR, digital x-ray, ultrasound, vascular diagnostics, etc.  Our licensed medical staff are experienced and dedicated to the ongoing care of our patients.  Revenues include product sales of custom orthotics, shoes, and braces. For further information, contact  CaliforniaPodiatry@gmail.com
 
PRACTICE FOR SALE – CONNECTICUT 
 
 looking to relocate or expand in Southern Connecticut here is a great opportunity to acquire an office with diversity in medical/surgical patient load plus ER coverage, wound care, and surgery at local hospital.
 Please reply to: dsharnoff@hotmail.com
 
PRACTICE FOR SALE – VIRGINIA 
 
Well-established routine and surgical practice in one of the fastest-growing areas of central Virginia. Conveniently located in a high traffic, commercial area.  All equipment and instruments included, assumable lease and ample parking.  Financials and photos available after proper paperwork executed.  No solicitations please.  Serious inquiries only.  Contact rvaprodiatry@gmail.com.
 
ASSOCIATE POSITION - ST. LOUIS 
 
Group practice seeking motivated DPM with initiative and leadership skills to join our group. Must have the ability to lead your own clinic. Group is fully automated, utilizes EMR, digital x-ray, etc. Base salary starts at $125k, with incentives to grow income to $200k+, includes malpractice coverage, health insurance, 401k. Please send CV to stlpodgroup@gmail.com
 
IMMEDIATE ASSOCIATE POSITION - CHICAGO
 
Seeking ABFAS Board Qualified/Certified associate for Chicago. EMR, digital x-ray, laser, ultrasound, surgery center & amazing support staff. Join a growing group based in Chicago & Suburbs. Salary & quarterly bonuses commensurate with experience & ability to grow your location. Available 401K plan, malpractice, CMEs. Send CV to chicagopodpractice@gmail.com
 
ASSOCIATE POSITION - CT (NORTH HAVEN AND FAIRFIELD)
 
Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to: Dr.Kassaris@yahoo.com
 
ASSOCIATE POSITION - MICHIGAN  (NOT METRO DETROIT AREA)
 
Not in the metro Detroit area. 2 offices, one DPM looking for a top notch candidate to join and then take over the practice.  Email resume to podiatricsurgeonspc@yahoo.com.
 
ASSOCIATE POSITION - CENTRAL CONNECTICUT (HAMDEN/NEW HAVEN) 
 
Seeking dynamic, ABFAS Board Eligible/Board Qualified podiatrist. Motivated individual with solid forefoot/rearfoot surgical training, PMSR-36/RRA. Local world-class hospital, available privileges/ ER call, working with prestigious residency program. Must be personable with impressive communication skills.  Excellent opportunity for buy-in/future partnership. Send cover letter/resume  newmedicalcareer@yahoo.com
 
ASSOCIATE POSITION – FLORIDA 
 
Once in a lifetime opportunity to practice in paradise, 3 year average over 7 figures. Senior podiatrist looking to retire seeks a well rounded practitioner for a 3-5 year transition .Established 27 year practice with 2 locations in Ft. Myers and Cape Coral, Florida. Hospital privileges pending skill. 1foot.ankle@gmail.com
 
IMMEDIATE OPENING FOR DPM - WASHINGTON DC 
 
Active DC License required now. Foot and Ankle Associates of Washington is growing. All facets of podiatry including office, ER, hospital surgery, and nursing homes. We are in three offices in the DC area. Applicants should be PSR-24/36. Competitive salary. Significant patient flow. EMR. Opportunity to get cases for boards. Hospital based practice. Must be board qualified. Come grow with us. Send CV and references to DCMDfootdoc@aol.com
 
ASSOCIATE POSITION (PART-TIME) – CENTRAL NEW JERSEY
 
Family Foot & Ankle Specialists is a busy podiatry office with multiple locations in Central Jersey. This is a great opportunity for a motivated and driven doctor to work in and grow our offices. The office provides every tool for success! Contact: Peter Wishnie, DPM drwishnie@stopfootpainfast.com
 
ASSOCIATE POSITION – SOUTHEAST VIRGINIA
 
Group practice seeking personable well trained podiatrist. ABFAS Qualified/Certified. Must be motivated with excellent clinical, charting and surgical skills – comfortable with all aspects of podiatry including limb salvage and flatfoot reconstruction. Practice has all modern conveniences and experienced support staff. Send email of intent (subject: New Associate) with CV: 1footassociate@gmail.com.
 
ASSOCIATE WANTED  - SOUTH FLORIDA
 
Hiring ABFAS BC or BQ surgeon to join our expanding team. All aspect of podiatric care required. Immediate associate position. ER, hospital call, rounds and office work. R U the Superstar that we require at our premier group? CV, LOR & how are you a superstar. klamdpm@hotmail.com
 
ASSOCIATE POSITION - BLOOMINGTON, IL  
 
Are you an energetic TEAM player looking to work with all-stars? WE have the position for you! Fast paced practice in Central Illinois is searching for a ROCK star to join our growing team.  Please visit www.HeartlandFootAndAnkle.com (look under employment opportunities) for details regarding this unique opportunity!  We can’t wait to meet you!
 
ASSOCIATE POSITION – LAPLATA, MARYLAND
 
Well-established practice with multiple offices located just south of Washington DC. Practice amenities include EHR, digital x-ray, state-of-the-art surgical suite, shoe stores, PADnet, and large support staff. Recently renovated hospital minutes away.  This is an extremely busy practice with high patient, new patient, and surgical volume with both forefoot and rearfoot surgery. We enjoy a large referral base due to our own practice marketer. We are looking for a highly motivated, personable individual. Must be well trained in forefoot and rearfoot surgery at PMSR-36/RRA. Competitive base salary with bonus structure. Send CV to: feet_r_neat@aol.com  
 
ASSOCIATE POSITION - PT/FT - NY (WESTCHESTER/ROCKLAND) 
 
Well-established, cutting-edge, modern private practice in multi-specialty office with over 45 years experience looking to hire an enthusiastic and passionate Podiatrist for PT/FT. We serve the Rockland, Westchester, and entire Tri-State Areas successfully with full diagnostic and treatment facilities, including: Fluoroscope, Diagnostic Sonogram, PinPointe Laser, Juvederm, ESWT, and in-house physical therapy. Affiliated with local hospitals and privileges available. Surgical skills preferred but not required. Join our friendly and knowledgeable office staff with decades of experience! An entrepreneurial and medical opportunity combined! Guaranteed signing bonus.  Send CV and cover letter to: linchpindpm@yahoo.com
 
ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA/COASTAL
 
Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital-based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com 
 
ASSOCIATE POSITION - NAPLES, FLORIDA 
 
Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office, multi-doctor practice. Hospital privileges available at 648 bed hospital system, 200-bed hospital system and multiple surgical centers. We rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Salary and bonus based on skills and experience, benefits including 401K. Current Florida license a plus. This a wonderful world class community. Email CV to Drgordon@gulfcoastfootcare.com.
 
ASSOCIATE POSITION -  KANSAS CITY 
 
You're not looking for a typical podiatry practice. We're not looking for the typical podiatrist. We need another doctor who understands the importance of creating an amazing patient experience as much as providing great medical care. You will be working with doctors who are committed to your success. If you are an entrepreneurial-minded doctor who wants to grow and eventually own part of an already successful practice, go to: www.YourFutureInPodiatry.com for full details.
 
WOUND CARE FELLOWSHIP - NEW YORK 
 
CPME APPROVED 12 month fellowship beginning July 1st, 2015. Hospital and clinic environment, with onsite Hyperbaric Medicine.  Working with infectious disease, dermatology, as well as plastic, general, vascular, and podiatric surgeons.  Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.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 16,000 DPMs. 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.
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.
Guidelines
  • To Post a message, send it to:    bblock@podiatrym.com
  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
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    RE: (Topic)
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    Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
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Barry H. Block, DPM, JD
 
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