PM News –February 20, 2006 #2,514 Editor-Barry Block, DPM,
JD
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--QUESTIONS ABOUT BILLING, CODING OR REIMBURSEMENT?-------
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www.codingline.com/silver.htm ). For current Codingline
topics of
discussion and more information about [Codingline-L], see
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this newsletter.
---------PODIATRISTS IN THE NEWS--------
WA DPM Provides Tips on Preventing Winter Foot Ailments
Winter chill can be tough on your toes. Not only do you run
the risk
of developing frostbite, but you could also be prone to
trench foot
and athlete's foot, experts say. According to the U.S.
Centers for
Disease Control and Prevention, wet feet lose heat 25 times
faster
than dry feet. To compensate, the body shuts down peripheral
circulation. Less blood circulating to the feet means less
oxygen
and nutrients, and skin tissue begins to die, a condition,
which can
lead to trench foot. Because wet feet get cold more
quickly,
they're also at an increased risk of developing frostbite.
Athlete's
foot, a fungal infection, is also more likely to thrive in
moist,
damp places such as feet when they're sweaty.
Fortunately, these prevention strategies can stave off all
three of
these conditions:
* Check your feet regularly to see if they are wet.
* If your feet are wet, dry them and put on a new pair of
dry
socks and dry shoes.
* Change your socks at least once a day.
* Do not sleep with wet socks on.
* Look for socks that are made of an acrylic fiber, not
cotton.
Acrylic wicks moisture away from the feet.
* Choose shoes that are waterproof and insulated, and be
sure
to check insulated shoes for leaks before use, advises DR.
DONALD
HOVANCSEK of the American Podiatric Medical Association.
* Make sure socks and shoes are not too tight, as this can
impede
circulation.
* Cover your feet with antiperspirant. The active
ingredient,
aluminum hydroxide, keeps your feet from sweating.
Source: International News Network [2/17/06]
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-------------AT THE COLLEGES-----------------
Armstrong Named Father of the Year By Chicago Father's Day
Council &
ADA
David G. Armstrong, D.P.M., Ph.D, Assistant Dean Dr. William
M.
Scholl College of Podiatric Medicineand Director of the
Center for
Lower Extremity Ambulatory Research (CLEAR) at Rosalind
Franklin
University of Medicine and Science has been selected by the
Chicago
Father's Day Council and the American Diabetes Association
to
receive an award as "Father of the Year." He
will be honored along
with five other outstanding fathers on Thursday, June 15,
2006 at an
awards dinner held in Chicago,
The Chicago Father's Day Council has partnered with the ADA
to bring
funding and awareness to the fight against diabetes. The
proceeds
from the dinner will benefit the ADA, a non-profit
organization
dedicated to preventing and curing diabetes and improving
the lives
of all people affected by diabetes.
*** SureFit Announces New 2006 Shoe Collection (Ad) ***
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------------PHARMACEUTICAL NEWS ----------------
States Want Info About Drugmakers' Gifts To Doctors
From mugs and pens to expense-paid trips, the pharmaceutical
industry's largess to doctors and hospitals has come under
increasing scrutiny in recent years. Now, a number of states
want an
even closer look. At least nine states are considering bills
that
would require drugmakers to publicly report how much they
and their
sales representatives give to doctors, hospitals and
pharmacists
each year. A few proposals go further: A bill under debate
in
Massachusetts would ban all gifts to medical professionals
from the
drug industry.
Source: USA Today [2/17/06]
-------- MEETING NOTICES/ COURSES --------------
There's still time to register for the Goldfarb
Foundation's
Intensive Board Review, Refresher, & Recertification
Course, March 2-
5, 2006, at the Renaissance Hotel Philadelphia Airport,
Philadelphia, PA; there are also spots left to take the
course
online "live" in the comfort of your own home.
Study Aids, such as
the 2006 Hershey Study Guide, a Mock Orals CD, Handout
Binder, and
Boards by the Numbers 2006 software are all included with
full-
course registrations. Also offered are the two-day
Recertification
Course and the Mock Orals Only tracks. Attain 32 CMEs by
registering
for the entire course; 13.5 CMEs for the Recert track.
Recertification can also be taken online "live."
Visit
www.goldfarbfoundation.org or call 800-841-3668, x14.
------------
For a list of all meetings go to:
www.podiatrym.com/meetings.pdf
-------------QUERIES--------------
Query: PodMed EMR
I'm wondering if there is anyone who can provide feedback
on the
PodMed EMR software.
Thomasin Hammer DPM, Spokane, WA, thomasink pol.net
--------- CODINGLINE CORNER --------------
Query: Coding Multiple Partial Ostectomies
A patient underwent partial excision of the fourth and fifth
metatarsal bases, in addition to partial excision of the
distal
portion of the cuboid. This was done to relieve the pressure
on a
plantar ulcer that would not otherwise heal because of the
constant
pressure. In the header of the operative report, the surgeon
identifies the procedure as midfoot exostectomy at cuboid,
fifth met
and fourth metatarsal bases, left foot.
Can CPT 28122 be reported multiple times?
Deb Arneson, BSN, ACS-OR, Burlington, NC
Response: Those of us who routinely take care of Charcot
feet, we do
this all the time.
The three separate bones you list are actually in intimate
contact
on the plantar aspect of the foot. I believe that a single
CPT 28122
(partial excision bone, tarsal or metatarsal) adequately
answers the
coding need of the whole procedure.
Walter J Pedowitz, MD, Linden, NJ
Additional responses can be found at http://www.codingline.com
-----RESPONSES / COMMENTS------------
RE: Topaz Microdebrider Radiofrequency Coblation (J.
Petrinitz, DPM)
From: Lowell Scott Weil, Sr., DPM
Our group has been using Topaz coblation (cool ablation) for
the
past 18 months on conditions such as Achilles tendinosis,
peroneal
tendinosis, and posterior tibial tendinosis. The anecdotal
results
appear to be favorable and equivalent to open procedures
with less
disability and post-op pain.
We are in the process of an ongoing, randomized,
double-blind study
comparing the results of Topaz coblation for the treatment
of
plantar fasciosis compared to a control of a percutaneous
plantar
fasciotomy. The methods used to evaluate each procedure
include VAS
pain scales before and 3 months post-treatment; E-Med
computerized
footprint studies pre and post-op; ultrasonic evaluation of
the
plantar fascia, pre and post op; SF-36 quality of life
tests, and
Roles & Maudsley evaluation.
The results will be published in about 6 months.
For more information about Topaz coblation, contact
http://www.arthrocare.com
Lowell Scott Weil, Sr., DPM, Des Plaines, IL, LSWSRaol.com
-------------
RE: Codes for Adhesive Tape and Coban (Tony Poggio, DPM)
From: Lloynessto, DPM
There are three components in the fees that are paid to
providers. "Practice expense" covers the vast
majority of supplies
for each code billed. Tape is one of those supplies. APMA
has fought
hard to insure fair reimbursement for these supplies and
every item
is detailed including how many Band-Aids, gauze squares,
"inches of
tape," are included in each code.
Physician work and malpractice expense are the other
components of
each code's total value. These issues are discussed at the
RUC
meetings several times each year. APMA is always present
during
these meetings.
Lloynessto, DPM, APMA RUC Rep, lloydpodyahoo.com
------------
RE: Height a Factor For Amputation Among Patients With
Diabetes
From: Patricis M. Schultz, DPM
News of the Canadian Medical Association study describing a
correlation between patient height and foot ulcer incidence
is very
gratifying to me. Over twenty years ago this coincidence
occurred to
me in my practice. In fact, I used to joke that my tall male
DM
ulcer patients and I looked like "Rocky and
Bullwinkle"!
The issue about the increased progression of nerve disease
in the
longest nerves was discussed in your excerpt. I have an
additional
hypothesis to consider - these tall people have the center
of
gravity of the torso at the end of a much longer lever arm
than a
shorter person. Supposing that talus is the fulcrum, and the
plantigrade foot is the other lever arm, apply the equation
of
weight x distance = weight x distance. These tall people
have more
weight at the end of longer lever arms. Then, due to the
length of
the lever arm, there is more angular acceleration as the leg
progresses over the midfoot (on the sagittal plane).
This acceleration magnifies the effect of the reactive force
of
gravity, which becomes focused upon the metatarsal heads as
toe-off
proceeds. No doubt that our colleagues with engineering and
physics
training will help to dissect this observation.
Patricis M. Schultz, DPM, Silver Spring, MD, pschultzstarpower.net
-----------CLASSIFIED ADS--------
Associate Position- Indianapolis and Suburbs
Group practice with multi-office, multi-hospital locations
looking
for "good fit" associates to grow and develop
into partners. We
offer diverse practice environments from pediatrics to
geriatrics,
nail surgery to rearfoot surgery, and diabetic foot care to
sports
medicine. New grads with surgical residencies a plus, but
mentoring
is available for others. More important than your training
and
experience is your attitude and work ethic. If you can
satisfy your
patients and produce profitable income, we have a position
for you.
We are a confident, very successful practice that offers
growth,
continuity, and a comfortable work environment in one of the
nation's fastest growing areas. Live in an area Money
magazine
ranked 24th in the nation as the best place to live in 2005.
Be proud of your profession, be proud of your life.
Experience
Hoosier hospitality...come and visit. You might like what
you find.
Curriculum Vitae and References to: Lawrence E. Lloyd, DPM,
FACFAS
Dir., Indiana Podiatry Group, Inc. larrydpmaol.com
FAX 317-595-6296
---------
ASSOCIATE POSITION – TEXAS
Mature 3-DPM general podiatry and surgery practice in the
Rio Grande
Valley of Texas is seeking a DPM to fill an Associate
position,
partnership will be considered after a period of 2-3 years.
Applicants should have at least 2 years of residency
training and
enjoy diabetic foot and wound care. Diverse patient
populations.
(VA, Community Health Clinics, Hospitals and 3 offices)
Good
practice environment in hospitals and community. Salary,
bonus and
benefit package offered. Interested DPMs should send a
letter of
intent along with a current C.V. to Complete Family Foot
Care, 812
Lindberg Ave. McAllen, TX 78501. Fax 956 971-9109
-----------
ASSOCIATE POSITION- NEW ENGLAND
Associate wanted to start this summer. Routine care,
diabetics,
biomechanics, sports injuries and steady surgery. Buy-in
for
partnership and ownership of building a possibility.
PSR-24.
Office podiatry skills (residency experience, office
observation or
work) important. Surgical training with focus on core skills
(bunions, met. osteotomies, neuromas/neurolysis, tendon
repairs,
some rearfoot) is important. facne11aol.com, give evening
number
(not cell), hospital name and residency director's name.
-----------
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If you are using or thinking of using ESWT, I have a new
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a look at http://www.orbasone.com.
Call 1-856-229-2939.
---------
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------------
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