PM News –January 24, 2006 #2,491 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--------
NYSPMA Presents Awards
One of the highlights of this past weekend's New York
Clinical
Conference was the awarding of some very well deserved
honors. The
recipients were:
Pioneer in Podiatry Award - Harry Sperer, DPM (Western
Division) who
graduated 1932 and retired in 2003 at age 93 after 71 years
practice.
Lifetime Achievement Awards- Glenn B. Gastwirth, DPM - APMA
Exec.
Director and Harry Moloff, DPM – (Suffolk Division)
Special Achievement Award - Amy R. Paulin, Assembly Member
for her
help in last year's successful residency legislation.
The APMA also presented a special recognition award to
Joseph
Cavuoto, DPM for longtime efforts on the behalf of PPAC.
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----------AT THE COLLEGES ---------
NYCPM Evaluating Opportunity to Guarantee Financial Strength
Over the last few years, the real
estate assets of the New York
College of Podiatric Medicine have increased in value
tremendously.
During the past several months, NYCPM has been approached
with
various opportunities for the College to convert its real
estate
assets in such a way that the financial strength and the
future of
both the College and the Foot Clinics of New York will be
assured.
One opportunity under consideration has been the sale of the
land,
as well as the College and Foot Clinics buildings, all owned
by the
College, to a real estate development partnership.
NYCPM has only
been willing to pursue this option if it was able to find an
advantageous alternative site for both institutions.
NYCPM has identified a potential site in Manhattan for the
College
and the Clinics, guaranteeing the independence of both
institutions. The College Administration has been concerned
above
all else with such considerations as upgrading NYCPM's
facilities,
providing more attractive dormitory living quarters, and
providing a
host of additional advantages to Faculty, Students, Staff
and
Administration – in addition to securing the financial
future of the
two institutions for future generations of students.
Because of sensitive ongoing negotiations, the College
Administration cannot announce any specifics until such time
as a
meeting of the minds has been reached with the parties
involved.
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----------- MEDICAID NEWS ---------
Medicaid Was Largest 2004 State Budget Item: Report
Medicaid represented the largest single category of state
spending,
consuming an estimated 21.9% of state budgets in fiscal
2004,
according to a report by State Coverage Initiatives, which
tracks
state efforts to expand healthcare coverage. By comparison,
elementary and secondary education -- the largest category
during
the five years from 1999 to 2003 -- represented 21.5% of
state
expenditures in fiscal 2004, and higher education accounted
for
10.5%.
Meanwhile, in recent months, many states were trying new
ways to
expand health insurance coverage, amid a growing number of
uninsured, rising healthcare costs, uncertainties related to
the
2006 federal budget and effects of the 2005 hurricane
season. State
efforts included both Medicaid expansions and market-based
strategies, such as a small-business initiative in West
Virginia.
States also "developed a new twist on mandating
coverage, with
Maryland passing legislation to require employers to pay
their 'fair
share' and Massachusetts considering an individual
mandate," the
group said in the report.
Source: Jessica Zigmond, Modern Healthcare [1/20/06]
-----------MEETING REPORT----------------
NY Clinical Conference a Smash Broadway Hit
It was a packed house for "Footlights" the 2006
New York State
Podiatric Medical Association Clinical Conference.
Headlining this
year's event were podiatric superstars David Armstrong, DPM,
PhD and
John Steinberg, DPM and endocrinology superstar Peter
Sheehan, MD
who lectured before a standing room only crowd. Attendence
hit a new
record and was up 6% from last year. A sold-out exhibit hall
was
extremely busy and the buzz was extremely positive as to the
future
of the profession.
Kudos to Larry Santi, DPM, Foundation President, Ed Buro,
NYSPMSA
President, and the Scientific Committee Drs. Joe Sciandra,
Bill
Spielfogel and Workshop Coordinators Drs. Tony Espositio,
Bob
Rampino, and Bruce McLaughlin, as well as NYSPMA Exec
Director Len
Thaler and his staff for a job well done.
-------- MEETING NOTICES/ COURSES --------------
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-Therapeutic Footwear & Birkenstock Custom Orthotic
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To Register call Annette Fernandes at 800-645-5520, ext.
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Refreshments will be served!
------------
For a list of all meetings go to:
www.podiatrym.com/meetings.pdf
-------------QUERIES--------------
Query: AVN of Talus
I have a 43 year old male with a large AVN of the talus.
This was
confirmed by both MRI and bone scan. There was no fracture
involved, probably more repetitive micro trauma. He is
currently
immobilized and in a bone stim. Has anyone had good results
with
cortical drilling of the talus, and if so, what is the post
op
course, i.e., weight-bearing? He is an otherwise healthy
male, 6'
6'' and 300 lbs.
Jim Giannakaros, DPM, Manahawkin, NJ, Jimpody3 aol.com
----------
Query: Implantation of Verrucae
Is anyone familiar with the surgical implantation of
verrucae to
promote an immune response?
Frank J. DiPalma, DPM, Athens, GA, fivetoes1946aol.com
--------- CODINGLINE CORNER --------------
Query: Burn Treatment Coding
A patient was treated in the emergency room for a chemical
burn that
happened at work.
The patient's foot had a first degree chemical burn. The
treatment
included a subcutaneous injection with calcium gluconate,
followed
by dressing application. No debridement was done at this
stage. How
would this treatment be coded?
Lisa Borscha, RN, Midwest Podiatry Services, Ltd, Oak Park,
IL
Codingline: CPT 16000 (initial treatment, first degree
burn, when
no more than local treatment is required) is the code for
1st degree
burn treatment. An E/M could be billed if the evaluation was
significantly in excess of the evaluation needed to proceed
with the
burn treatment (and should be billed with modifier
"-25" if both are
used).
The subcutaneous injection would be billed CPT 90772
(therapeutic,
prophylactic or diagnostic injection [specify substance or
drug];
subcutaneous or intramuscular) with the appropriate
"J" code for the
supply.
The only thing I'd question here is whether this ultimately
is a
first degree burn or not. My research into this treatment
found that
the injection given is used when deeper tissue involvement
from the
chemical burn is suspected (otherwise, one article stated
that a
topical gel of calcium gluconate is used). I'm not a
physician so I
may be completely off base on this one, but your statement
about "no
debridement done at this stage" leads me to believe
that you're
anticipating debridement may be necessary at a later point
in time
due to the depth of the burn. If that is the case, instead
of
billing CPT 16000 for this initial treatment, you may wish
to use
CPT 16020 (dressings and/or debridement of partial-thickness
burns,
initial or subsequent; small [less than 5% total body
surface area]
based on the fact you indicated that a small portion of the
body was
involved). Although debridement CAN be part of the treatment
for a
partial thickness burn, it isn't required.
Joan Gilhooly, CPC, CHCC, Deer Park, IL
-----RESPONSES / COMMENTS------------
RE: Orthovisc (Lloynessto, DPM)
From: Jay Goldstein, DPM
I have used hyaluronate made by two other companies. I use
it most
often immediately following hallux limitus surgery, but I
have no
way of separating the results of my surgery from that of the
injections. I have never charged for the injections, so I
cannot
relate reimbursement information.
The smallest needle I have been able to use is 23 g. To the
best of
my knowledge, the companies sell their products in 2.5 cc
units, but
I use a maximum of 0.5 cc's for foot injections. I believe
the
products are approved only for knee injections. If Orthovisc
has an
FDA foot indication, it must have been approved since I last
researched the subject.
I keep the product, which is quite expensive, refrigerated.
Jay Goldstein, DPM, Portland, OR, jcgdomehotmail.com
----------CLASSIFIED ADS--------
ASSOCIATE POSITION – Raleigh, NC
Associate position in Raleigh, NC. Two-doctor, two-office
looking to
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hardworking, well-educated and skilled with good PR ability.
Fax
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-------------
Position Available – OH
Ohio Associate to Partner track for BE/BC podiatrist.
Reputable,
stable, growing practice with an established patient base,
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benefits
package. Send CV and references to: podiatrypositionyahoo.com
--------------
Practice For Sale – Queens, NY
Extremely Successful Podiatry Practice For Sale. Nets 300K
Full Time (5 Days)-can be 6. 40 year old practice-No Bone Sx
Done-
No HMOs. Medicare and Union Ins.- GREAT INCOME/OPPORTUNITY
Serious Inquiries Please -516-780-4865
-----------
Position Avalable – 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.
-----------
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