PM News –January 12, 2006 #2,483 Editor-Barry Block, DPM, JD
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--QUESTIONS ABOUT BILLING, CODING OR REIMBURSEMENT?-------
Just send them to PM News by replying to this newsletter.
Your
questions will be forwarded to Codingline for responses
which will
then be posted on PM News. PM News subscribers are invited
to
explore Codingline (www.codingline.com), and register for
[Codingline-L], Codingline's free moderated listserv
focusing on
reimbursement and practice management issues: coding,
billing,
collections, appeals, and more. [Codingline-L] free
registration:
www.codingline.com/silver.htm ). For current Codingline
topics of
discussion and more information about [Codingline-L], see
the end of
this newsletter.
---------PODIATRISTS IN THE NEWS--------
Armstrong, WU Named Editors at Foot and Ankle Quarterly
Data Trace Publishing Company has announced that DR. DAVID
G.
ARMSTRONG will assume the responsibilities of Editor in
Chief for
Foot and Ankle Quarterly, joined by DR. STEPHANIE C.S. WU as
Editor.
Both Dr. Armstrong and Dr. Wu are affiliated with the Dr.
William M.
Scholl College of Podiatric Medicine at Rosalind Franklin
University
of Medicine and Science in North Chicago, Illinois. Dr.
Armstrong
holds the positions of Professor of Surgery, Director of
Scholl's
world-renowned Center for Lower Extremity Ambulatory
Research
(CLEAR) and Director of Clinical Research at the Rosalind
Franklin
Comprehensive Diabetes Center.
Dr. Armstrong is well known and highly respected in the
podiatric
and orthopedic fields. He and his team have published well
over 200
peer-reviewed manuscripts and book chapters. Dr. Armstrong
is one
of the most sought after lecturers and educators in the
field of
foot care, internationally. Dr. Wu serves as an Assistant
Professor
in the Department of Surgery and is a Fellow within CLEAR.
She is
quite often described as a "rising star."
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----------- DIABETES NEWS---------
Insurers are Pennywise, Pound Foolish – NY Times
Insurers, for example, will often refuse to pay $150 for a
diabetic
to see a podiatrist, who can help prevent foot ailments
associated
with the disease. Nearly all of them, though, cover
amputations,
which typically cost more than $30,000.
Source: Ian Urbina, The New York Times, [1/11/06]
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-------- MEETING NOTICES/ COURSES --------------
Does your practice produce too many headaches and not enough
income?
Consider learning the skill of functional manipulative
therapy at a
two-day hands-on workshop in Napa, California, where Rue
Tikker,
DPM, teaches the therapy he's been practicing for years. He
discusses its place in an integrated practice, demonstrates
the
manner in which it's applied, its efficacy in the treatment
of
sprains, and its utilization in the relief of neuroma pain,
metatarsalgia, heel pain, and tired, aching feet. You earn
15 CE
contact hours through the California PMA, a CPME-approved
sponsor.
Your total investment is $1,500, or $2,500 for two
partners/friends
in one workshop. Dates by arrangement. Podiatrists who've
used this
technique report 75 to 80 percent of patients get amazingly
fast
relief and they've boosted monthly practice income
$8-10,000. E-mail
rtik napanet.net, phone 707-265-6333, http://www.podiatrywo
rkshop.com
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------------
For a list of all meetings go to:
www.podiatrym.com/meetings.pdf
-------------QUERIES--------------
Query: Peri-operative Management of DVT
My patient is a 37 yo healthy active BF w/ post-partum
history of
left calf deep vein thrombosis in 1998. There are no other
risk
factors. She takes 1 ASA qod and has been worked up for
left foot
bunionectomy, having failed prolonged course of exhaustive
conservative measures What is the standard of practice in
terms of
any and all prevention or peri-operative measures? Would
anyone
consider doing this distal 1st MT osteotomy under local w/
dilute
epi to the 1st ray? I so, at what concentration (if less
than
1:200k)?
William W. Godfrey DPM, MAJ, MS, US Army, Ft. Polk, LA,
williamtrekkieearthlink.net
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--------- CODINGLINE CORNER --------------
Query: Cactus Removal Billing
I have a patient who stepped on a cactus resulting, as you
can
imagine, in the burying of many cactus needles into the
bottom of
her foot. The patient has a partial anesthetic neuropathy,
and
walked on the needles for 12 days prior to coming into the
office.
After checking the level of her neuropathy, I found I could
remove
the superficial buried needles with occasional use of
topical
anesthesia. I removed 25 cactus needles by using a tissue
nipper to
remove the keratotic tissue that had formed over the
needles, then
by incising through the skin, and extracting from the
superficial
subcutaneous tissue area each needle using a hemostat. How
should I
bill this?
Brad Habuda, DPM, Fort Myers, FL
Codingline Response: I would look at CPT 28190 (removal of
foreign
body, foot, subcutaneous), along with diagnosis code, ICD-9
729.6
(residual foreign body in soft tissue).
Since you had so many cactus needles to remove from
different sites,
you could try billing for each removal using a
"-59" modifier, but
you may find the payer balking when you submit the code x25.
I think
in this case, I would bill CPT 28190-22 along with a letter
of
explanation citing the 25 needles, submitting photos (if
available),
and describing the tedious work (op report) needed to remove
all of
them. Of course, you should increase your fee accordingly.
Denise Paige, CPC, Long Beach, CA
Additional responses are posted on http://www.codingline.com
-----RESPONSES / COMMENTS------------
RE: FPMA to Fight Proposed Limitation of Scope of Practice
From: W. David Herbert DPM, JD
I am concerned when I hear that a state may attempt to
restrict the
right to practice a profession. For years the courts have
considered
the right to practice a profession a type of property right.
I
believe any state action to limit the right to practice
podiatric
medicine could be subject to the "takings" clause
of the fifth
ammendment of the U.S. Constitution. To properly employ this
argument a constitutional scholar should be consulted.
W. David Herbert DPM, JD, docnurse5sbcglobal.net
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------------
Practice For Sale – Queens, NY
Extremely Successful Podiatry Practice For Sale Queens,
N.Y.- Full
Time (5 Days) -can be 6. 40 year old practice-No Bone Sx
Done- No
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Serious Inquiries Please -516-826-7477.
-------------
Position Available – Naples, FL
Florida, Naples- Great opportunity for PSR- 24/36 BE/BC
podiatrist
with strong surgical skills. Hospital privileges available
at 548
bed hospital system and multiple surgical centers. Candidate
should
be able to and want to perform rearfoot surgery including
Charcot
reconstruction. Candidate needs to be ethical and motivated.
Established practitioner or new practitioner OK. Base,
percentage,
benefits including insurance and 401K. Fax CV to
(239)566-8778.
-----------------
Associate Position - Kansas City, MO
Excellent opportunity for hard working, ethical podiatrist
to join a
growing podiatric medical and surgical practice. Must be
board
eligible/certified. Three year residency (RPR/PSR-24)
preferred.
Partnership opportunity. Wonderful place to raise a family.
Please
fax CV to 816-455-8901.
-----------
EQUIPMENT FOR SALE – ESWT
FDA- Approved High Energy Orbasone ESWT Device. Excellent
Condition,
barely used. E-mail footcarecomcast.net for pricing and
additional
information.
-----------
HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO/NORTHWEST INDIANA
Chicago-Home Physicians specializes in house calls to the
elderly
homebound. Full and part-time positions available in
Chicago/Northwest IN. Competitive Compensation, including
malpractice. Contact Scott Schneider. Phone-773-292-4800.
Fax-773-
486-3548. E-mail sschneiderhomephysicians.com
www.homephysicians.com
---------
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------------
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