* "My spelling is Wobbly. It's good spelling but it Wobbles, and the letters get in the wrong places." -- A. A. Milne

*
I have a spelling checker
It came with my PC
It plainly marks for my revue
Mistakes I cannot sea
I've run this poem threw it
I'm sure your please to no,
It's letter perfect in it's weigh
My checker tolled me sew
-- anonymous

Despite quotes and poetry to the contrary, we should keep in mind that how we spell, punctuate and otherwise communicate does influence how others perceive us (and our offices).

~  Gayle

From:  Holly Mollo
re:      Source for Extra-Large Shoes  (Volume 54)

How about Pedors? They have flexible tops that will accommodate his feet while providing a hard enough sole for orthotics. The only thing I don't know is how wide they come. Worth a try!

Holly Mollo
Centre Footcare
State College, PA

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from:  Gail Bennett, PMAC
re:     Source for Extra-Large Shoes  (Volume 54)

I wonder if [a state podiatric association or assistant's association] would consider helping this man you speak of.  The other thought is does he belong to a church?  They will help people out at times.  I know my church is always helping people in need, they have a special offering once a month that goes into what they call the "Deacon's Fund" and it's used at the Deacon's discretion to help people just as this gentleman.

Gail Bennett, PMAC
Spokane, WA

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From:  Maggie Bova, PMAC, PRT
re:      Region III Assistants' Program

I have a question: I am Vice President of NJPMAA and also a certified member of ASPMA.  I heard recently that Region III may discontinue the assistants program next year.  Has anyone heard anything on this matter?  I wanted to ask Joan Gordon who I think still coordinates that seminar.  Can someone please get back to me on this matter?  I would also like to thank Gayle for her continuing a newsletter.

Thanx,
 
Maggie Bova, PMAC, PRT

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From:  Lynn Homisak, PRT
re:      Region III Assistants' Program

Hi Maggie,

I'm sorry to say that yes, you are correct about the Region III Meeting.  According to the Committee, a decision was made at their last meeting to not sponsor a 2004 meeting for assistants based on "the perception that the members for the most part are not interested in supporting the program."  As Co-Chair of the assistant program, I was extremely discouraged by this decision and feel it is a step backwards not only for the continued educational growth of the podiatric medical assistant, but for the respected position we hold in our profession.  Our enrollment may have declined over the past couple of years, but still we had a strong, enthusiastic crowd and prior to this recent notice, it was highly regarded as one of the most successful assistant regional meetings across the country.  For those in NJ, PA and DE (and nearby states).....it was THE meeting to attend....a professional annual tradition that goes way back!

I feel there were a number of contributing factors (some that could have been worked out.....some out of our control) that resulted in this decision and while I had hoped that we would have an opportunity to address some of these issues before the cement was laid, I was mistaken.  The decision had already been made.

I've been told that feedback from both Region III Members and Assistants will be heard and taken into consideration, so for those of you who are directly affected by this change and want to have an active voice in the future of "our" program, please speak up now.  Feel free (either you, your doctor or BOTH of you) to email me and I will be sure to forward your comments on to the powers that be.

Region III has always been a leader in recognizing the educational value of the assistant and the worth they have brought to their member's practices by supporting a professional venue for them to share and learn.  It is sad to think that this long-lived philosophy on which Region III was built is no longer strong enough to make a difference....and that as a result, this may finally be the end of a tremendous era.

Lynn Homisak, PRT
LynnPRT@msn.com


*_*

"In the confrontation between the stream and the rock, the stream wins--not through strength but through perseverance."   -  unattributed

*_*

I was recently forwarded an article regarding offshore transcription and the possible dangers that may be attached to it.

The original article was part of a LAZARUS AT LARGE piece written by David Lazarus. The article in part said:
“A woman in Pakistan doing cut-rate clerical work for UCSF Medical Center threatened to post patients' confidential files on the Internet unless she was paid more money.  To show she was serious, the woman sent UCSF an e-mail earlier this month with actual patients' records attached.
The violation of medical privacy  -  apparently the first of its kind  -  highlights the danger of ‘off shoring’ work that involves sensitive materials, an increasing trend among budget-conscious U.S. companies and institutions.
U.S. laws maintain strict standards to protect patients' medical data.  But those laws are virtually unenforceable overseas, where much of the labor-intensive transcribing of dictated medical notes to written form is being exported.“

I read this and was not surprised, but don’t read into this that it is an overseas issue.  When you contract with a firm for transcription, for example, you have a Business Associates Agreement (BAA) with that company.  The purpose of the BAA is to protect and insulate you from outsourced liabilities and it extends the reach of HIPAA beyond covered entities.

A rogue employee can commit such an act whether here on main street USA or half way around the world.  Your local computer software company could just as easily have a disgruntled employee and release all of your patient information on the web as easily as this transcriptionist.

Your responsibility is to protect yourself with a BAA; economic market forces will take care of the rest.  If a company has an incident as described, it is up to that company to respond aggressively to the employee and prosecute to the full extent of the law in order to instill confidence in their clients that they take this matter seriously.

This is also a great example of why you must have a BAA with any non-covered entity who has access to your patient data.  You should also make sure that your BAA has a requirement that the associate has liability insurance to protect you in the event that one of the BAA’s employees does breach confidentiality.

By: Raymond F. Posa, MBA
Technology Advisor to the American Academy of Podiatric Practice Management
President, New Jersey HIPAA

Any questions or comments can be addressed to Mr. Posa by E-mail: Rposa@NJHIPAA.com

You can review previous installments from Mr. Posa at
http://www.footzine.com/FZ_H.htm

The Question:

Can you tell me what the following code numbers are for ... 20650, 27687 and 28285?

Susan J. Houck
Oklahoma City, OK

The Answer:

20650  describes the insertion and/or removal of a pin or wire into or out of a bone. This is typical for osseous procedures where you need fixation, such as a hammertoe repair. Medicare considers the insertion of the pin/wire part of the procedure, however some third party payers will pay separately for insertion of a pin/wire. If the pin/wire is percutaneous the removal is considered included in the RVU for the procedure. If a return to the operating room is necessary to remove then pin then it can be separately billable.

27687  Gastrocnemius recession is a procedure used primarily to treat gastroc equinus whereby the gastroc tendon is lengthened typically in a tongue and groove manner. (reference McGlammary Comprehensive Textbook of Foot Surgery).

28285   Hammertoe repair describes the repair of hammered or crooked toe via soft tissue and/or osseous methods.  This code includes just about anything that can be done on the toe with the exception of nail work.  It does not include a MTPJ release 28270 (reference Correct Coding Initiative).

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

Thanks for the continuing answers, comments, questions and ideas.  Keep 'em coming!

 ~  Gayle