PM News - March 11, 2006

PM News –March 11, 2006 #2,530 Editor-Barry Block, DPM, JD

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**********IN YOUR MAILBOX SOON*********** 

We just mailed the March 2006 Buyer's Guide Issue of
Podiatry 
Management. At 284 pages, it's the largest journal in the
history of 
podiatric medicine. In it you'll find over two dozen
well-written 
and informative articles, columns, and features, as well as
two CPME-
approved CME articles. 

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Nalfon(tm) 200. Foot pain doesn't wait. Why should relief?

--QUESTIONS ABOUT BILLING, CODING OR REIMBURSEMENT?-------

Just send them to PM News by replying to this newsletter.
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questions will be forwarded to Codingline for responses
which will
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www.codingline.com/silver.htm ). For current Codingline
topics of
discussion and more information about [Codingline-L], see
the end of
this newsletter.

---------APMA COMPONENT NEWS ----------------

ACFAS Announces 2006-2007 Board of Directors

The American College of Foot and Ankle Surgeons (ACFAS)
announces 
its 2006-2007 Board of Directors. 

President – James L. Thomas, DPM, Birmingham, AL
President-Elect – Daniel J. Hatch, DPM, Greeley, CO
Secretary-Treasurer – John M. Giurini, DPM, Boston, MA 
Immediate Past-President – John J. Stienstra, DPM, Union
City, CA

Directors 
Joseph M. Anain, DPM, Buffalo, NY
Edwin L. Blitch, DPM, Charleston, SC
Mary E. Crawford, DPM, Everett, WA
Lawrence A. DiDomenico, DPM, Youngstown, OH
Michael S. Lee, DPM, Des Moines, IA
Jerome S. Noll, DPM, Naples, FL
Douglas G. Stoker, DPM, Salt Lake City, UT

All directors will be installed at the Annual Business
Meeting, 
March 22, 2006, during the ACFAS 64th Annual Scientific
Conference 
in Las Vegas, NV.

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----------PM JURY VERDICT REPORTER ---------

Foot Patient Claimed Surgery Wasn't Timely or Done Right
(New Jersey)

Facts: In June 1998, plaintiff Craig Glaser, a mechanic in
his 40's, 
visited his podiatrist for treatment of a fractured sesamoid
in his 
left foot. The podiatrist treated him with anti-inflammatory

medication, gave him a boot cast and crutches and told him
to 
elevate his foot, ice it and keep off it. 
Glaser went to the podiatrist for weekly follow-up
treatments for 
the next four weeks and then saw the podiatrist on a monthly
basis. 
In October 1999, the doctor decided that Glaser needed
surgery to 
remove fracture fragments in his foot, and performed the
surgery in 
November. He was left with chronic pain, he claimed. 

Glaser sued his podiatrist for medical malpractice, claiming
that he 
should have performed the surgery sooner. He also claimed
that the 
surgery was performed improperly because the fragments
should have 
been removed from the top of his foot, and instead the
doctor 
removed them from the bottom of his foot, allegedly causing
nerve 
damage. 

The defense argued that the initial treatments performed by
the 
podiatrist met the required standard of care and that
surgery was 
not immediately necessary. The defense also contended that
the 
surgery was performed appropriately according to the
required 
standard of care. The defense also claimed that Glaser
failed to 
follow his doctor's instructions to use crutches and keep
his weight 
off the foot. 

Injury:  Glaser claimed that as a result of the delay in
performing 
the surgery and the improper performance of the surgery, he
could 
not return to his job as a mechanic because he was unable to
remain 
on his feet for extended periods of time due to pain in his
foot. 
Lost wages were stipulated at approximately $30,000. Glaser
also 
sought damages for pain and suffering. 

Result: The jury found the defendant not liable. 

Plaintiff's Expert Witness: Expert: Lawrence Levine,
D.P.M., Cherry 
Hill, NJ
Defendant's Expert Witness: Jonathan Haber D.P.M.,
Caldwell, NJ

Source: Verdict Search

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--------  MEETING NOTICES/ COURSES --------------

For a list of all meetings go to:
www.podiatrym.com/meetings.pdf

-------------QUERIES--------------

Query: Malposition, 1st MPJ Arthrodesis
 
I am treating a 41 yo female who underwent a first MPJ
arthrodesis 
approximately 6 months ago for hallux rigidus. Her initial
post-op 
course went as expected with radiographic union of the
arthrodesis 
site noted by 8 weeks. As she had increased her activity
over the 
subsequent months, she developed lateral ankle/STJ pain and
plantar 
hallux IPJ pain and mild edema (no pain at the arthrodesis
site). 
She describes having difficulty pushing off her great toe.
The 
lateral weight-bearing x-ray shows the sagittal plane
position of 
the proximal phalanx to be parallel to the weightbearing
surface.  
There is no frontal or transverse plane malposition.
 
Treatment to date has included orthotics and immobilization,
with 
limited improvement. Opinions about conservative and
surgical 
options are appreciated. In particular, is a dorsi-flexion
osteotomy 
at the arthrodesis site a reasonable option to consider? 
 
Stephen Merena, DPM, Essex Junction, VT, stephen.merenaverizon.net

----------------

Query: Kidde Replacement Canisters   

Does anyone have information on a supplier for the Kidde
Tourniquet 
System - in particular refills, parts, etc.?
 
Darryl Burns, DPM, Salinas, CA, darrylburnsmsn.com

Editor's note: The following was previously posted on PM
News and 
can be found using the search engine on htt
p://www.gillpodiatry.com/files/NewProducts.pdf  

Roger Friedman, DPM, Elyria, OH 

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-------- CODINGLINE CORNER --------------

Query: ICD-9 216.7 - Benign Neoplasm of Skin 

When does ICD-9 216.7 (benign neoplasm of skin) become the
correct 
code to use to describe a skin lesion? What would be
reasonable 
examples of such lesions? 

T. Todd Horak, DPM, Homewood, IL

Response: The ICD-9 descriptor of the 216.x code series
includes 
neoplasms such as blue nevus, dermatofibroma, hydrocystoma, 
pigmented nevus, syringoma, and syringoadenoma. 

I would think that the appropriate use of this code would be

dependent on whether 

1) The neoplasm was deemed to be histologically benign 
2) The neoplasm approximated the types of lesions listed in
the ICD-
9 216.x descriptor (dermatofibroma or 
syringoma versus a callus or wart) 
3) The neoplasm in question doesn't have a more specific
diagnosis 
code 

Stacey Hernandez, Woodland Hills, CA 

Additional responses can be found at http://www.codingline.com

-----RESPONSES / COMMENTS------------

RE: A Good Week For The Profession
From: Allen Jacobs, DPM

I thought that I might share my week with readers ,
particularly 
young readers of PM News.
 
On Tuesday evening I lectured to a full house of plastic
surgeons, 
general surgeons, and vascular surgeons on infection
management in 
wound care. They were all very attentive and many took notes

throughout the lecture.
 
The following day I was reading the February issue of the
Journal of 
Bone and Joint Surgery, and there was a wonderful article by
Thomas 
Chang and other DPM's on the management of ankle arthritis.
 
The following day, I picked up the most recent issue of
Diabetes 
Care to read an equally well done article by Dr. Lawrence
Harkless 
and associates.
 
Our profession has come a long way from the days when a
podiatrist 
could not obtain privileges at a reputable hospital or have
a 
scientific paper published in a reputable journal.

Allen Jacobs, DPM, St. Louis, MO, allenthepodsbcglobal.net

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PSR-24. Office 
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-----------

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------------

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