I received a letter from Dr. Martin Marks this week, and wanted to share it with you.  You may have read or heard of him or his alter-ego, "Dr. Footsie".  While FootZine is not in a position to contribute to his efforts in a traditional manner, we do have a large and varied group of subscribers, who may in turn know of others who could offer support for Dr. Footsie's work.  I love it when the news covers podiatrists who do good!  You'll find his letter below.

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Not long ago we mentioned that email providers are increasing their anti-spam efforts.  We have recently seen an increase in the number of "bounced" FootZine emails, and most have some variation of a message saying that FootZine is an "Untrusted Sender".  I have also heard from people saying they haven't received several issues recently, although theirs had not been returned to me.  In some cases, the email service has decided that it should be "Bulk" or "Junk" mail, so it goes into that folder instead of the recipient's Inbox. (I'm in good company  -  I know of some instances where APMA email gets diverted there, too.)

You should have the option to change those settings in your email program.  Look for the opportunity to check something like "This is Not Junk Mail" next to email that you want to receive in you regular Inbox.  Other programs make it as simple as adding welcome email correspondents to your email address book, or otherwise designating the sender as "friendly".

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In the last couple of weeks, I've participated in a few discussions about tourniquets.  As we heard, the very familiar pneumatic "Kidde Cuff" has been discontinued.  No problem, you say?  Mine still works fine, you say?  Did we mention that the little replacement cannisters have also been discontinued?  Without them, the pneumatic cuff won't work at all.  From what we've heard, the new ankle/leg tourniquets are electric and, of course, expensive. 

As promised last week, Mike Moscow has faxed information about the new system that Universal carries to those who provided their fax numbers.  The unit is made by Delfi and appears to be smaller and lighter than the Kidde system.  I have heard from a few people who are researching systems for their offices or surgery centers, and they will share their resources with us as they gather more information.  Please feel free to pass along any relevant discoveries that you make.

~   Gayle

From: Martin Marks, DPM
re:     "Dr. Footsie "

Hi Gayle,

I just stumbled across your name while surfing the net.
I am a Podiatrist from Southern California and wanted to share with you what
I am doing with promoting the profession as well as working with inner city youth
against violence and drugs, using foot-like cartoon characters.
STEP into our website: www.drfootsie.org
We are trying to take this message worldwide and need all the SUPPORT we can get.
If we are ever to market our profession, we have got to get to the youth.
If you’re interested email me. MAM@drfootsie.org

Sincerely,

Martin
Aka Dr Footsie

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From:  Sue Dissinger
Hi Gayle,

We would like you to put the dates of our State Meeting on the Footzine. The Goldfarb Meeting in Pennsylvania will be held Friday and Saturday, Nov. 14 and 15 at the Hilton in Harrisburg, PA. The ASPMA Certification will be given. Anyone interested can contact me at dissinge@redrose.net. Thanks Gayle!

Sue Dissinger
Pres. PPMAA

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This meeting and others are listed on FootZine's "Calendar" page, found at http://www.footzine.com/FZ_4.htm

This past weekend we spoke to an awesome group of assistants at the Connecticut Podiatric Medical Association’s Annual Symposium.  We had two special guests attending the program, Richard Ornstein (my 83-year-old dad) and Tyler Ornstein (my 8-year-old son).  Dad has had the opportunity to listen in on some of our other programs throughout the country and even was one of the lecturers at the Region III assistants programs in Atlantic City two years ago.  It was just the three of us for an overnight journey from New Jersey to Connecticut and a true blessing to have the generations bond.  But as you can imagine, putting an energetic 8 year old (and almost as talkative as his dad) and impatient grandfather together for a six hour odyssey in the car can drive anybody to check in at the funny farm!

My dad was a traveling salesman selling children’s clothes and has people skills equal to none.  He is intelligent, warm, perceptive, appreciative, loving and has the knack of making everyone he touches feel valued and important.  He is quite perceptive and is typically right on target.  While driving home from Connecticut I solicited his opinion on how our assistant programs can be improved.  He related that an inherent problem is that many assistants do not realize that they, like doctors, are professionals.  They are not front, back or billing staff, but are a direct extension of the doctor and our profession. 

Assistants must take a hard look at the perception of the patients, whose health and well-being they serve, as to their value and importance.  My dad’s comment was an eye opener to the reality that it is not just the doctor who needs to realize the value of their staff, but more importantly, the staff understanding the professional stature they possess and their absolute importance to the practice.  Our patients’ well-being and quality of life depends on our team of assistant and doctor.  They put us on a level playing field, so let’s not trip on the bases.  Thanks, Dad, for your infinite wisdom!

Previous "Gems" can be found on their own pages of the FootZine.com web site, at
http://www.footzine.com/FZ_90.htm

Often I am asked, “What diagnoses codes can I use to get paid?”.  In my experience there are two diagnoses that help get the claim paid on the first submission. 

The first is 729.5 (pain in limb).  This is an excellent diagnosis for the E/M service done on the first time you see the patient for a new problem.  This code would be the primary diagnosis and the specific condition diagnosis would be the diagnosis for any procedure done.  For example a new patient is seen for heel pain and we evaluate them, do radiographs and inject.  The E/M would be coded 9920X with diagnosis of pain in limb (729.5).  The radiographs would have the same diagnosis.   The injection would have the diagnosis of plantar fasciitis or heel spur syndrome.

The second diagnosis is 998.83 and is often used when the patient is outside the global period for a procedure but still is having problems.  You would bill the E/M unmodified with the nonhealing surgical wound diagnosis (998.83).

The Question:

How can I bill insurance, be it Medicare or other ins for an E&M code for complication during post op period?  I can not seem to find a modifier that will work.
Thanks for you help and the very informative newsletter.

Cindy Bryce, PMA

The Answer:

Any complication related to a procedure that occurs in the global period is considered part of the global and not separately billable unless a return to the OR is required in which case modify the procedure with -79 (return to OR for related problem during global period).

If there arises a problem unrelated to the procedure then -24 (unrelated E/M service during global), -78 ( unrelated procedure during global period)


Crystal-Clear Coding tips by Dr. Ward are posted on the FootZine web site on this page:
http://www.footzine.com/FZ_C.htm

*_*  Coming Soon: 
Durable Medical Equipment & In-Office Dispensing *_*

Coming soon to FootZine is a new series by Richard Levin, DPM. He is a DME guru who will write a DME/IOD (in-office dispensing) article for FootZine once a month.  Dr. Levin's articles will be archived on our web site at:  http://www.footzine.com/FZ_D.htm

Psychic income, Northwest style:  Freshly caught and cooked Dungeness crabs recently presented by an appreciative patient  -  Life can be pretty good here!

Keep cool, and don't forget to write!

~  Gayle