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PM News

The Voice of Podiatrists

Serving Over 16,864 Podiatrists Daily


January 31, 2015 #5,284 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

optima5


PM NEWS QUICK POLL

FINAL DAY TO VOTE

Quick Poll

How do you treat onychomycosis?

Nuvolase


PODIATRISTS AND THE SUPER BOWL
FL Podiatrist Provides Super Bowl Injury Report to ESPN West Palm 
 
With all eyes on Super Bowl XLIX this week, West Palm Beach Dr. Jonathan Cutler discussed the most recent and relevant injuries affecting the Seattle Seahawks’ and New England Patriots’ players. How are the injuries expected to affect the players’ performance and will there be any key players sidelined during the game? “We’re keeping an eye on two Seahawks players, Cornerback Richard Sherman and Safety Earl Thomas,” says Dr. Cutler. 
Dr. Jonathan Cutler (L) on ESPN Injury Report
 
“Sherman has an elbow injury, but his MRI was negative so he potentially has an ulnar nerve contusion. If it's a slight contusion, he should be close to 90% by game time. If it’s more severe, he may have issues defending the fade or high pass. Thomas has a dislocated shoulder, which may affect his reach and could, in turn, affect his tackles. He may play at 100%, but, again, be cautious on how he tackles.”

Gordon2 Labs


PODIATRISTS IN THE COMMUNITY
WA Podiatrist Volunteers at Homeless Connect Project
 
At Project Homeless Connect, the annual roundup of services, benefits, and hands-on care hosted by the Council for the Homeless and St. Joseph Catholic Church in Vancouver, Kaiser Permanente podiatrist Dr. David Griffin and a couple of foot-care nurses were reaching for feet that have spent too much time cold, wet, and on the streets. Griffin offered William Wegener, an unemployed welder whose diabetes has led to some numbness in his feet and hands, some instruction and brochures about caring for his extremities and avoiding any more nerve damage.
 
Dr. David Griffin
 
"I just want to make sure we get your feet in shape so you can work," Griffin told Wegener. "You see trouble, you get help right away, okay?" Then he passed Wegener on to the donated footwear and shoe-fitting experts of Vancouver shop Fit Right NW. "We just want to provide good, quality care," Griffin said. "This is a great way to help some of the most neglected of our fellow citizens." He added that 80 percent of Americans are wearing the wrong-sized shoes.
 
Source: Scott Hewitt, The Columbian [1/29/15]

Dr.Comfort


IN THE COURTS
Spring Lake Pays Accused NJ Podiatrist $275K
 
The borough has paid $275,000 to a podiatrist and former resident who claimed the police department wrongly prosecuted him for attempting to steal a local widow's multimillion-dollar estate. The podiatrist, Dr. Ronald J. Sollitto, was the central figure in a headline-grabbing case involving his eccentric, elderly neighbor, Madeline Stockdale.
 
Sollitto's lawsuit accused Police Chief Robert J. Dawson Jr. and Sgt. William Coyle, both of whom have since retired, of waging a "vindictive prosecution" against Sollitto, aimed at discrediting him and bolstering the first aid squad's case. The lawsuit accused Coyle of helping to sway the grand jury toward handing up an indictment through false testimony. The settlement, signed Nov. 24, expressly states that the borough's payment is "not an admission of liability, fault, or wrongdoing." 
 
Source: Shannon Mullen, Asbury Park Press [1/19/15]

Blainelabs


CODINGLINE CORNER
Query: Nursing Facility vs. Group Home Setting E/M
 
I was asked to see patients in a group home setting. In looking at the E/M categories, I believe that a group home is in the nursing facility category. I have not seen patients in a nursing home/facility for a number of years. Are there requirements such as having an order from the attending or primary care physician to see the patient? I also remember something about not being able to bill for an initial E/M, as only the admitting PCP can bill for that type of visit in the facility. Is that correct? 
 
Louis Scotti, DPM, Nesconset, NY
 
Response:  I recommend looking at the Domiciliary, Rest Home, (e.g. Boarding Home), or Custodial Care Services codes: CPT 99324-99337. The place of service code is 14 for Group Home and 33 for Custodial Care. These CPT codes do not have a medical care component. They are distinguished by new or established patients. It is best to contact the facility and ask how they are designated before seeing patients. Even if you are provided a room to use for your work, please do not bill place of service 'office', as in order to do that, one would have to bear the expense for the office setting. 
 
There must be an initial order on record from the patient's PCP for podiatry care. I recommend asking whomever contacts you if the order is written for each patient. I have not seen any guidance that this order must be renewed in a certain period of time. The new patient codes for Domiciliary, Rest Home, Boarding, or Custodial Care will closely fall into the same realm as office visit coding. The Initial E/Ms for nursing home patients (which do not distinguish new vs. established) would not, as they are designed for the first visit by the PCP for a detailed/comprehensive evaluation for the entire care of the patient. This may or may not include the written order for podiatry care. 
 
Karen Hurley, CMM, CPC, Lakewood Ranch, FL
 
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

aetrex


RESPONSES/COMMENTS (NON-CLINICAL) - PART 1A
From: Barrett Sachs, DPM, Greg Caringi, DPM
 
In response to  Dr. Udell's query about high deductibles, my office policy for over 30 years has been payment is due on that day, or we do not see the patient. My office manager verifies all deductibles before we see the patient and informs them what their approximate payment will be. If they are not prepared to pay at that time, we re-appoint them. Can you imagine going into your local grocery store and either telling them you'll pay them later or not at all?
 
Barrett Sachs, DPM, Plantation, FL
 
We are dealing with the same problem. We have not had much success with our collection agency. We have collected only $200 over a period of 3 years. To show how little this affects patients, we had a patient whose account we turned-over to the collection agency who still did not pay, but called to schedule surgery on his opposite foot.
 
As a more positive approach, we are seriously looking into taking credit card information from every patient and getting their written permission to charge balances to their credit card. We have not been able to figure out the security logistics at this point. Our billing software vendor Kareo will handle the process, but they will charge a much higher rate than our present credit card processor.
 
Greg Caringi, DPM, Lansdale, PA
milehigh

RESPONSES/COMMENTS (NON-CLINICAL) - PART 1B
From: Lisa Merkow, CPC, Larry, Huppin, DPM
 
We have found an effective solutions for patients who ignore our statements and phone calls. It's called DoctorDefender.com. We joined for a small annual fee, and when a patient refuses to pay us, we enter their name into the website and they send a notification letter to the patient. It is surprising how many patients send in their payment after receiving this letter. If for any reason they don't pay, we add them to the database so that other doctors can search and avoid seeing patients who have a pattern of non-payment. In addition, it's much more cost-effective than paying a collection agency.
 
Lisa Merkow, CPC, office of William Beaton, DPM, St. Petersburg, FL

To eliminate the issue with high deductibles, for the past year, we have utilized a “credit card on file” program. We now require all patients to have a credit card on file if we will be billing insurance for them. 

Using a feature in our practice management system (Athenahealth), once each year, we swipe the credit card of each patient. Athena’s credit card partner (Elavon) stores the credit card information securely. The patient signs a one-year contract that gives us permission to bill...
 
Editor's note: Dr. Huppin's extended-length letter can be read here.

Richie


RESPONSES/COMMENTS (NON-CLINICAL) - PART 1c
From: Jordan R. Stewart, DPM
 
The issue of high deductible plans is certainly impacting all medical practices. The only way to combat this issue is to collect for all services provided on the date of the service. This is best accomplished by keeping a spreadsheet with the fee schedule for the procedures you commonly perform. We check each and every patient’s benefits before they are seen and we tell them how much of their deductible is remaining and what services it applies towards. We notify patients of the office policy before they come to the office. Most patients abide by the policy, yet there are some who leave the office or cancel their appointments as they don’t plan on paying. 
 
As far as I am concerned, these are the same patients whom you are currently sending bills. At the end of the day, this comes down to a business decision. The reality is that we are doctors, but we are also in business. This process takes lots of work on the front end, but it is well worth it as you accounts receivable will be very low. If you want to survive in practice, this is the only way to go, and I would apply this towards co-insurance as well. If patients have overpayments, we simply refund the money through our bank’s online bill pay. Patients love this part.
 
Jordan R. Stewart, DPM, Timonium, MD

Dr. Remedy


RESPONSES/COMMENTS (NON-CLINICAL) - PART 2
From: Paul Kesselman 
 
This question continues to persist in various forms, despite a plethora of thorough responses from noted coding experts such as Drs. Goldsmith, Borreggine, and others. The simple fact is that Medicare DOES NOT pay for foot orthotics in the overwhelming majority of patients that most podiatrists will treat. Without repeating the policy in full, you need to meet ALL of these coverage requirements:
 
1) The patient must have a shoe which is an integral part of a leg brace (the shoe must be attached to the brace);
2) The orthotic must be placed into the shoe which is attached to the leg brace;
3) You must be the DMEPOS provider of 1 and 2.
 
Again, you must meet all three of the above. Why does Medicare unwittingly pay for more orthotics than other covered DMEPOS? This is because suppliers are telling Medicare they have met all three requirements by attaching the KX modifier to their custom foot orthotic codes (L3000-L3020). If one needs to bill Medicare for custom foot orthotics in order to receive a patient responsibility (PR) rejection, one should amend the foot orthotic code (L3000-L3020) with the GY modifier. Once you receive the EOMB with the rejection from your DME MAC, you can bill the patient's secondary insurance (subject to the secondary insurance carrier's policies). For more information, reference the Orthopedic Footwear Policy on your Regional DME MAC website.
 
Paul Kesselman, DPM, Woodside, NY

realm


RESPONSES/COMMENTS (NON-CLINICAL) - PART 3
From: Charles Morelli, DPM, Robert Kornfeld, DPM 
 
I appreciate Dr. Trepal’s comments, and agree with him that I may have taken some of those comments out of context as they relate to the unethical dispensing of in-office products. Anyone would agree that if a doctor dispensed products, braces, shoes, etc., for the sole purpose of gaining, profit, it would be unethical. I initially took offense, as did others, based on my conversations with some podiatrists that day, and felt the need to respond as I pride myself as being an ethical practitioner. 
 
My apologies if some of my comments were construed as casting aspersions on the integrity of any panelist. As I re-read my post. I can see where that could have been the case and I could have chosen my words more carefully.
 
Charles Morelli, DPM, Mamaroneck, NY 
 
Although I was not present for the round table that Dr. Morelli commented on, I think his comments are extremely pertinent. It is my opinion that ANYTHING a doctor does to assist in healing the pathology his patients present with, cannot (and should never) be considered unethical. I take STRONG offense to anyone who has the audacity to tell me how to practice podiatric medicine. I take stronger offense when the system we work in, i.e. capitalism, is used as a blanket condemnation of any physician involved in office dispensing. If there are any doctors out there who think that dispensing products from the office is unethical, DON'T DO IT! My guess is that many of these same docs condemning office dispensing are also operating on asymptomatic bunions. I'll stick with the magic potions.
 
Robert Kornfeld, DPM, Port Washington, NY

axcc1


YOU CAN'T MAKE THESE THINGS UP

RE: Outrageous Nails of the Day

Patriot nails of Liz Lyon, DPM (Boston, MA)

Okay Seahawks fans, whatcha got?

Source: Dr. Arthur Gudeon

MEETING NOTICES

SBW

ACFAS


kent


cherrydec


CLASSIFIED ADS
POSITION WANTED 
 
3rd year surgical resident seeking position starting this summer. Looking to help practice grow for a potential long-term position. Self motivated, hard working, honest and personable. Well trained in all facets of podiatry including rearfoot, ankle, reconstruction and trauma, in addition to wound care and general podiatry. Specific interest in sports medicine and trauma. From Chicagoland with ties to the Midwest. Currently looking in Illinois, Wisconsin, Iowa and Colorado, but willing to move for the right situation. Please contact me at PMNewsAd@gmail.com if interested.
 
ASSOCIATE POSITION - NYC
 
New York City Podiatry office seeking an Associate. Part-time or Full-time. Please send  resume podiatry053@gmail.com.
 
ASSOCIATE POSITION - TEXAS
 
Seeking three-year surgically trained podiatrist for busy podiatric medical and surgical practice in Texas. Must be hard-working,   open to direction, and willing to do all phases of podiatric foot and ankle care. Please send CV, and salary history  to: jmh6122@yahoo.com
 
ASSOCIATE POSITION - EAST ORANGE, NJ 
 
Part time or Full time position available in modern up-to-date practice. PSR 24-36 trained individual, but previous practice experience a plus. Looking for the right person to buy into the practice within 1 year. Send CV to DRFOOT44@gmail.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 – MIAMI, FL
 
Associate needed - house calls, etc. Miami, Dade, Florida. Please contact Lcohn1952@aol.com 305-338-4668
 
IMMEDIATE POSITIONS AVAILABLE - BUFFALO,  ALBANY, AND SYRACUSE NEW YORK 
 
Looking for podiatrists to see residents in nursing homes and skilled nursing facilities in Buffalo, Albany, Syracuse and surrounding areas.  Great opportunity for full-time or part-time income. Positions available immediately! Email inquiries to: phasetwopodiatry@gmail.com
 
ASSOCIATE POSITION – FL 
 
BQ in Foot & RA required: candidate for 1 year post-residency fellowship in FL. Add to your knowledge and skills on: Reconstructive RRA surgery, arthroscopy of STJ / ankle, sports medicine and practice management. ACFAS poster and research project. Starts 8/2015. Send resumes to: mny1029@gmail.com
 
ASSOCIATE POSITION – TEXAS 
 
Seeking three-year surgically trained podiatrist for busy podiatric medical and surgical practice in Texas. Must be hard-working, open to direction, and willing to do all phases of podiatric foot and ankle care. Please send CV, and salary history to: jmh6122@yahoo.com
 
ASSOCIATE POSITION - INDIANAPOLIS METRO NORTHEAST 
 
If you are a talented and well-liked experienced surgeon, resident, or fellow who wants to develop a career in Indiana, we can make it happen. We are looking to expand service lines. If you have the drive to do what it takes, step forward. Change your life.  100-125K+, benefits and malpractice. Send cover letter, CV, and references to john.lloyd@lloydpodiatry.com
 
ASSOCIATE POSITION - SOUTH CAROLINA 
 
South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Salary range $120k-$140k (base + bonus) and benefits. Please send Letter of Interest and CV to:scdpmjobs@gmail.com
 
ASSOCIATE POSITION - MICHIGAN
 
Multi-doctor practice looking to add associate for two offices in Flint, MI area. Partnership opportunity for right person. We are looking for a surgically proficient doctor. Rearfoot/ankle training is a plus, but not a necessity. Competitive salary with paid vacation and seminars. Patient schedule available “now” from a retiring associate. Email resume to giordanodpm@hotmail.com.  
 
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 LEADING TO PARTNERSHIP NORTHERN VIRGINIA
 
Well established high volume  Podiatric Surgical practice seeking associate to join 4 doctor/2 office opportunity. Excellent salary plus incentives and great benefits. All Board Certified Fellow Podiatric Surgeons highly respected in the medical community. Prefer forefoot and rearfoot reconstructive surgical trained practitioners only. Please email CV and references to medical 622@aol.com. If you are seeking a position in July 2015 when you finish your residency, this is an opportunity you should investigate.
 
EQUIPMENT FOR SALE - Q-CLEAR MULTI-FUNCTION LASER 
 
Q-Clear Laser Multi-function laser, FDA-cleared Fungus Toenails, and Warts. Less than three years old. Excellent condition, includes training certification and  marketing materials.  e-mail Footcare@comcast. net
 
LIMB SALVAGE FELLOWSHIP – SAN FRANCISCO
 
University of California, San Francisco Medical Center is currently accepting applications for its 12 month Limb Salvage fellowship beginning July 1, 2015. The Fellowship includes advanced techniques in limb salvage with many research opportunities. The fellow will receive: $60,000 salary and benefits with 2 fully funded conferences to attend.  Please submit a Letter of interest, CV, and 3 Letters of recommendation to: Dr. Alex Reyzelman,, Director at alexander.reyzelman@ucsf.edu.
 
DIABETIC FOOT AND WOUND FELLOWSHIP – DALLAS, TX  
 
One position for a 12-month TMB-approved Diabetic Foot and Wound fellowship beginning July 1, 2015. Candidate must have completed a podiatric residency/plastic surgical residency/general surgery residency and be eligible for Texas Medical License. Training involves all aspect of diabetic foot management. Curriculum focuses on surgical limb salvage, and medical management of the complex wound patient. Interested candidates should email their CV, personal statement and 3 letters of recommendation to: amanda.murden@utsouthwestern.edu. UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.
 
PM News Classified Ads Reach over 16,000 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.
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Barry H. Block, DPM, JD
 
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