Volume 17 17 5 Issue Volume

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1st MTPJ A-Z Workshop ACFAS and Seminar Schedule Coming to You September 24–25, 2010 ACFAS and Division 6 A new partner project between Midwest the College and four ACFAS Minneapolis Airport Marriott Regional Divisions is bringing Bloomington, Minn. something special to neighbor- hoods across the nation—con- October 8–9, 2010 ACFAS and Division 2 venient, local foot and ankle Northwest/Canada surgery continuing education Embassy Suites - Downtown contact hours! Portland, Ore. Members have sometimes asked why the College doesn’t ankle surgeons an opportunity to enhance their skills and October 22–23, 2010 provide its unparalleled educa- advance their current knowledge of surgical practice. The ACFAS and Division 5 Florida tion courses in their backyards. program will begin with a welcome reception and sharing and Division 14 Southeast Your College has listened, and is of case presentations by both faculty and attendees. The Francis Marion Hotel collaborating with the Divisions next day will encompass lectures, demonstrations, panel Charleston, S.C.

to provide the first-ever local discussions and a lab. Healthcare industry representatives For more information and to series, “1st MTPJ A-Z Workshop will also be on hand with a full range of products and ser- register, visit acfas.org. and Seminar.” vices to explore. These affordable hands- Take advantage of this local learning and sign up on courses will give foot and today at acfas.org. n In This Issue Share your research with ACFAS Comments Incorporated in colleagues at the next ACFAS Annual Scientific Conference. CPME 320 Revisions Details on page 4

In February, the ACFAS Board of revised proposed changes that incorporated Directors made several recommenda- suggestions offered by ACFAS. • The requirement for number of clinic tions to the Council on Podiatric Medical Specifically, the board had recom- encounters be maintained and the mini- Education’s (CPME) proposed revisions to mended that: mum number of medical histories and the document CPME 320, “Standards and • The word “surgical” be retained from the physical examinations be substantially Requirements for Approval of Podiatric current PM&S terminology for residencies. increased. Residencies.” The board made its recom- • In accordance with the standard prac- mendations in response to CPME’s call for tices of other accrediting bodies, profes- CPME has now issued a new call for comment from the residency community of sional membership recommendations comment on the revised changes to CPME interest. should not appear as a residency program 320, open until October 1, 2010. The In all, CPME reports it received more requirement. ACFAS board will consider further recom- than 150 written comments, and held five • CPME reconsider the feasibility of future mendations at its July meeting. n open forums for input on the proposed program directors being ABPOPPM- changes. In late April, CPME unveiled certified. perspective 2 What is Your Sociosphere? By Michael S. Lee, DPM, FACFAS President

Now, more than ever, we are in uncertain 2.0 movement have forever changed nized and respected everywhere. The times. Our world is changing. how information is disseminated. letters “FACFAS” are opening doors These transformations affect us all In coming years this will affect how worldwide and surgeons around the in many ways. Some are positive, some ACFAS provides e-learning, patient globe are accessing ACFAS resources are not, and many of them have not yet education and member networking. like never before. But, unlike other defined how they will impact our lives. We must balance these new communi- organizations, only board certified or As these matters become more defined, cations tools with the printed commu- qualified surgeons are invited into the including healthcare reform, an economic nications that many of our “seasoned” College’s membership. recession and the digital age, ACFAS must members still prefer. So, look for • New Intermediaries — As the ease of continuously work to meet your ever- ACFAS to have an increased presence access and volume of information on changing needs. All of these factors — and on Facebook and Twitter, increased the Internet increases, so does the need many more — affect your sociosphere. e-Learning offerings, smartphone apps, for quality assurance of that informa- One of the interesting and unique discussion boards and similar tools. tion. We have all experienced the patient dynamics of membership associations like who has received misinformation ACFAS is that the members (you) are the ACFAS will continue from the Internet. So, I often direct my owners, the customers and the workforce to define and promote patients to ACFAS’ consumer website, of the organization. This has been referred the specialty of foot and FootHealthFacts.org, for reliable patient to as the “Triple Helix” of professional ankle surgery. education. This unique site is also “HON associations. No other business has this Certified” — the gold standard for trust- unique “organizational DNA.” worthy online health information. (PS: The Board of Directors represents a • Inverted Workforce — Basically, If you haven’t expanded your profile on very small segment of ACFAS’ volunteer Baby Boomers will be “retreading” this website, you should!) workforce and an even smaller percentage rather than retiring. The young foot • Brawn & Bucks — As the Baby of ACFAS’ owners and customers. But the and ankle surgeon is better trained Boomers age and their children reach board’s role is to position ACFAS appro- now than ever before, so our seasoned middle age, the U.S. healthcare system priately in its own sociosphere, given all members will need to continually will be challenged like never before. of the external and internal forces affect- retread their skills with the most up- Add to this the uncertainty of health- ing the College. to-date training and techniques, online care reform, and the way ACFAS Last year, along with ACFAS and in-person. You can’t teach experi- positions itself and its members will Executive Director Chris Mahaffey, I ence — you must gain it — and in the become increasingly important. One attended the Symposium for Chief Elected CME programs we offer ACFAS must thing is for sure, ACFAS will continue and Chief Staff Officers sponsored by balance the needs of young, “better”- to define and promote the specialty of the American Society of Association trained foot and ankle surgeons with foot and ankle surgery to patients, gov- Executives, aka the “association of asso- those of experienced veterans. ernment, the media, and the healthcare ciations.” One of the more interesting • Maturing Globalization — The community at large. discussions dealt with the many trends re- world is getting smaller, so increased These trends, along with the College’s shaping an association’s sociosphere … in collaboration with like-minded foot six strategic initiatives, will guide us other words, factors that will impact the and ankle surgeons around the world through the next few decades and shape College’s direction in the coming years. will grow. As ACFAS has started its our collective sociosphere. We need your Here are just a few: international efforts with relation- help; after all, you’re not only a member, • Reverse Mentoring — Generation Y, ships in Europe, Australia and Asia, but also an owner, a consumer, and the the Millennial generation, and the Web we have learned the College is recog- workforce! n

ACFAS Update Volume 17, Issue 5 News from the College 3 Complimentary Membership which could result in the e-newsletter not stop me and ask questions as I spoke, and for New Residents being delivered regularly, or at all. they had a lot of questions!” The ACFAS Division Presidents’ Council If you are not receiving your issue of Immediately following her presenta- will continue to support first-year podiat- This Week @ ACFAS every Wednesday tion, the club had a meeting and elected ric surgical residents by providing com- afternoon, you can find it on the ACFAS its officers. Newly elected club president plimentary first-year membership in website. Don’t let spam filter issues keep Michael Stastny says: “Most of the students the College. This month the College will you from the latest news of activities and in the DPM program here envision them- begin informing new residents of this offer, research in foot and ankle surgery! Visit selves partaking in a 36-month residency which gives them the benefits of member- any time to get the latest issue or browse the as future foot and ankle surgeons. Our edu- ship with dues waived for one year, begin- entire archive at acfas.org. cational and professional journey will be ning October 1. This is a direct value of greatly supplemented by the many learning $112, plus additional savings through New Employee Joins ACFAS tools provided by ACFAS. Furthermore, we member pricing on conferences, products Headquarters Staff expect ACFAS will bring to us the newest and services. ACFAS welcomes a information relevant to our education, pro- “The Division Presidents’ Council recent addition to the fessional development, and ability to pro- is excited to be able to offer this to new headquarters office. vide the best patient care.” residents. We believe that supporting our Kristin Hellquist “The visit by Dr. Crawford was tre- young residents is not only of benefit to Cunningham, MS, mendously uplifting,” Stastny contin- them, but to our profession as a whole,” CAE, is the College’s ues. “It truly demonstrated the desire of says council Chair Kimberly Eickmeier, new director of health continued on page 7 DPM. “Access to the College will help policy, practice advocacy and research. start their career with a strong educational She brings 19 years of experience in gov- base, and provide a connection to a com- ernment relations and association man- Simple. Brilliant. munity of their peers – the best and bright- agement, having previously worked at Your Scheduling Solution est foot and ankle surgeons in the country.” the National Council of State Boards One of the council’s goals is promo- of Nursing, the American Academy of tion of the highest educational standards for Dermatology, the Joint Commission residents, who are the future of the profes- and Abbott Laboratories. She will serve sion. “Some of the benefits that first-year ACFAS members in all matters regarding residents will be able to access at no cost practice management, scope of practice, include our prestigious Journal of Foot & credentialing and privileging, coding and Ankle Surgery, and the College’s premiere reimbursement, and state and federal regu- website, which offers many educational lations, legislation and policy. opportunities including podcasts and litera- A listing of all staff and their responsibili- ture reviews,” explains Eickmeier. ties can be found at acfas.org/contactus. “I look forward to welcoming our first- New ACFAS Student Club at year resident members!” adds Eickmeier. “I Eppointments is the premier appointment scheduling software. hope their journies in podiatry and as a resi- WesternU It is fl exible, fully customizable and extremely easy to use. dent members of ACFAS give them many The newest ACFAS Student Club is up In-Offi ce and Web-Based Scheduling great and rewarding experiences.” and running at the Western University Patient Online Features from your Web Site, including: • complete patient registration information College of Podiatric Medicine, or • online appointment scheduling automatic email reminders Find This Week @ ACFAS “WesternU.” ACFAS Immediate Past • Online President Mary E. Crawford, DPM, vis- ® Are you missing issues of the College’s ited WesternU in late April to address its e-newsletter, This Week @ ACFAS? Your inaugural podiatric class. Visit our Web site for more details or contact us now for a IT service provider may sometimes update “The lecture went well,” reports product demonstration and start seeing more patients today! or change its e-mail spam filter settings, Crawford. “I encouraged the students to 866.376.7070 | www.eppointments.com

www.acfas.org education 2010 CME Calendar 4 For information on upcoming programs 1,500 Foot and Ankle Surgeons Can’t Be Wrong visit acfas.org, or call (800) 421-2237. Here’s what your colleagues had to say about ACFAS’ 2010 Annual Scientific Conference: October 1–2, 2010 (Fri/Sat) Coding and Practice Management “ACFAS is the cream of the crop for content, pre- Seminar sentation, access to faculty and quality of the labs. Parc 55 Hotel I look forward to next year.” San Francisco, CA “The conference made me proud of my career 15 continuing education contact hours choice and excited for what lies ahead.” “Best conference for foot and ankle surgeons, bar October 16–17, 2010 (Sat/Sun) none.” Trauma of the Foot and Ankle It’s not too early to think about attending the next Annual Scientific Conference Surgical Skills Course in Fort Lauderdale, Fla. Preconference workshops will take place on March 8, and the Scientific Education and Research scientific conference runs March 9–12, 2011. Don’t miss out on this preeminent edu- Institute (SERI) Denver, CO cational event! 16 continuing education contact hours

Share Research at the Conference November 5, 2010 (Friday) Become part of the education at ACFAS’ Annual Scientific Conference by submitting Tendon Repair Surgical Skills your research manuscript or poster for consideration. Selected manuscripts and Course posters will present the most current research and demonstrate the advantages of Intercontinental Dallas Hotel and evidence-based practice to your peers in foot and ankle surgery. Wright Mobile Lab Key dates: Dallas, TX • August 2, 2010 — Manuscript submission deadline • October 1, 2010 — Poster submission deadline 8 continuing education contact hours

For submission guidelines and more information, visit acfas.org/ftlauderdale. November 6, 2010 (Saturday) Tendon Repair Surgical Skills Course Intercontinental Dallas Hotel and The Dysfunctional Forefoot Wright Mobile Lab New Scientific Session Video Dallas, TX Visit ACFAS e-Learning to view the latest Scientific Session video, “Dysfunctional 8 continuing education contact hours Forefoot.” Foot and ankle surgeons present approaches to address a variety of health challenges, including multiple and stump neuromas, toe deformities, hallux varus, and November 20–21, 2010 (Sat/Sun) Arthroscopy of the Foot and Ankle damage from prior surgeries. Surgical Skills Course ACFAS members can earn free continuing education contact hours through study Sold Out Orthopaedic Learning Center (OLC) of this or any of the Surgical Skills videos. Both members and nonmembers can pick up Rosemont, IL contact hours with purchase of the Surgical Techniques DVDs from ACFAS e-Learning. To be waitlisted, please contact Whenever you’re looking for reliable information on the diagnosis and treatment Maggie Hjelm, [email protected] of foot and ankle conditions, the resource you need is at your fingertips in this online 16 continuing education contact hours archive. Check back often for current topics and information at acfas.org/eLearning. December 11–12, 2010 (Sat/Sun) Arthroscopy of the Foot and Ankle The Latest Podcasts: Recent Scientific Session Videos: Surgical Skills Course • Early vs. Late Metaductus Management • Musculoskeletal Tumors Sold Out Orthopaedic Learning Center (OLC) • Cavus Foot • Ankle Arthritis Rosemont, IL

• Gearing Up for Residency • 2nd MPJ To be waitlisted, please contact n • Chronic Ankle Pain: Arthrodiastasis Maggie Hjelm, [email protected] 16 continuing education contact hours

ACFAS Update Volume 17, Issue 5 Practice Management 5 Key Medicare Billing and Coding Errors in Podiatry By Christine E. Weikert, DPM, FACFAS

It has always been extremely important to readily available if requested by Medicare. ed to the hospice patient’s terminal condi- properly code and charge for medical ser- Your visit note should clearly state the medi- tion. Omitting the GW is a common error vices rendered. Even the most seasoned cal services rendered and any treatment and and can cause claim rejection. Physicians physicians and staff find coding and bill- plan. The documentation should be kept in and staff should take time to review the ing to be an area of concern and frustration. the patient’s nursing home file, with a copy patient record, noting if the patient is Medical documentation for each date of in your records. enrolled in a hospice program. service should reflect the services provid- Another top billing error is failure to Having your codes, modifiers and insur- ed. Overbilling and underbilling can make report the correct patient name associated ance identification numbers submitted clean a practice a target for audit and actions. with the insurance identification number. the first time allows your office to see more Documentation and the part it plays in reim- A major area of concern with nursing home paid claims and fewer claim rejections. bursement are vital to the financial health of patients is recording the correct demo- Reducing your billing office error rate will your practice. graphic information, which must match the improve your productivity and cash flow. A good place to start in understanding patient’s insurance card. This is an impor- services and coverage would be to review tant first step in claims submission. While Christine E. Weikert, DPM, FACFAS, is the local coverage determinations (LCD) demographic and insurance information is president and CEO of The Podiatric Billing for your Medicare area. These are a guide to important with all patients and their different Specialists, LLC. coverage for services rendered to Medicare insurance policies, it seems more difficult to continued on page 6 patients and provide information to deter- obtain correct and up-to-date information for mine acceptable procedure and diagnosis the nursing home patient. codes, time limitations and modifier usage. Your staff must realize there are no gray HealthCare Associates Physicians and staff should be aware of the areas when it comes to obtaining correct Credit Union LCD for the services they provide — and demographic and insurance information. www.hacu.org keep up on any revisions to LCDs. Your office should have policies and proce- One of the top billing errors is attributed dures for the staff to follow. There should be Business Lending to lack of medical necessity, when an audit no question about what information is need- shows the documentation does not support ed and how to input this information into the If “banks” can’t help, it’s good to know… HealthCare can. the level of service provided. In Medicare system. durable medical equipment billing, the med- Establishing a good relationship with • Practice acquisition & owner buy out ical necessity must be clearly documented nursing home staff allows you to contact • Building: of ce, clinic, surgery center with the use of the KX modifier and this doc- someone who can readily assist and provide • Equipment purchases umentation must be on file. More often that accurate information for billing. Whenever • Working capital lines of credit not, physicians provide these services but possible, a scan or copy of the insurance card fail to properly document services or medi- clearly providing the name, identification cal necessity in the record. number and telephone number of the insur- Physicians rendering services to ance company is beneficial. Keep in mind patients in a nursing home should carefully patients often change insurance plans, so it’s follow specific guidelines. There must be important to constantly verify this informa- Sold Out documentation of the request for podiatry tion. Training your staff is key. services by the referring or requesting phy- Another denial seen too often on claims sician, patient or patient’s family. Standard is for patients enrolled in a hospice program orders are not an acceptable means for who are receiving other medical services

providing specialty services. A copy of such as podiatry. Modifier GW is used to Contact Norma Cantrell today at the request for podiatry services should be indicate that services rendered are not relat- 630.276.5730 or 800.942.0158 x 5730

www.acfas.org RESEARCH Practice Management 6 continued from page 5 2010 Clinical and Scientific Research Grant Optimize Your Practice Management As a leader in advancing foot and ankle surgery, ACFAS annu- Change is a constant of the medical prac- ally awards grant monies to ACFAS Fellows and Associates to tice environment. Keep your practice fund research. The 2010 grant application is now available for poised for progress by refreshing your download from the ACFAS website. Deadline for applications is skills at the next ACFAS Coding and October 15, 2010. Practice Management Seminar in San Only proposals meeting evidence-based medicine levels of Francisco, October 1–2, 2010. evidence 1, 2 or 3 will be considered. To find out more, download Experienced faculty will coach the application and view past winners, visit acfas.org/grant. you through issues such as the latest changes in EMR and CPT, coding and Take Advantage of ACFAS Research Resources documentation tips and pitfalls, and The College is committed to promoting research and evidence- understanding how regional differences based medicine. The ACFAS website provides a number of in Medicare administration can affect payment. research resources for physicians, including the Journal of Participants at May’s seminar in Chicago gave the faculty Foot & Ankle Surgery, Scientific Literature Reviews, and tools an average rating of 4.8 on a 5-point scale, and praised the pro- to help members get started with clinical research projects. gram for its effectiveness and value. Reap the benefit for your Explore them all by searching “Research and Publications” at practice by attending, or sending your office manager or coding acfas.org. n and billing staff. For more information call 800-427-2237 or visit acfas.org. n

“1,975 new patients!” Greg Renton A New Orlando, FL website “1,089 new patients!” Robert J. Abrams, DPM, FACFAS Equals new patients Newhall, CA “724 new patients!” Mitchell Waskin, DPM, FACFAS Richmond, VA

Websites starting at $995

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ACFAS Update Volume 17, Issue 5 Practice Management PATIENT OUTREACH continued from page 5 7 Optimize Your Practice Management ACFAS in the News The newsletter is available in both at any time during this search, the poten- ACFAS announced the revised Clinical English and Spanish. To download and tial patient can move to the right side of the Practice Guideline, “Diagnosis and personalize a copy for your patients, the screen to search for a local ACFAS member. Treatment of Heel Pain,” with a nationwide next entry on your blog or the next commu- You can use the resources of press release on April 30. The release has nity health event, visit acfas.org/footnotes. FootHealthFacts.org to educate your exist- been picked up in 192 media outlets with ing patients. “Patient Reference Forms” placements on WTVF-TV, Nashville, New Podcasts Available are available at acfas.org/marketing for Tenn.; WBTV, Charlotte, N.C.; KHNL- Looking for more valuable foot health infor- directing your patients to specific informa- TV, Honolulu, Hawaii; KMPH-TV, Fresno, mation to share with your patients? Two new tion on the site. You can add your practice Calif.; and WTEN-TV, Albany, N.Y. patient education podcasts, “Diabetes and name and contact information to the forms, ACFAS provided tips for prevention Your Feet” and “Hallux Rigidus,” are now as well as the name of the condition(s) they of foot injuries in an April news release, available on FootHealthFacts.org. should read about, reinforcing the informa- “Power Mowers Pose Danger to Feet.” The Each podcast features a panel of physi- tion you’ve provided during the office visit. story has appeared on 110 news outlet web- cians who answer the most common ques- FootHealthFacts.org is information sites with a combined readership of more tions patients have on the health issues written by ACFAS members for ACFAS than 65,190,000 visitors per day. presented. Additional podcasts on other foot members. Direct your patients to this site The new ACFAS position statement health topics are also available by visiting with the confidence that they will find the on total ankle replacement surgery was the FootHealthFacts.org. highest quality foot and ankle health infor- topic of a June 2 news release, “Effective mation on the Internet. n Alternative Treatments for Chronic Ankle FootHealthFacts.org – Instability.” Your Resource for Patients, ACFAS Fellow Karl Collins, DPM, Old and New of St. Louis, Mo., was featured in the May Consumers looking for reliable informa- issue of Men’s Health and the March issue tion about foot and ankle health are turning of Prevention on the risks of contracting to FootHealthFacts.org, the new website MRSA with ingrown toenails and improp- linking potential patients with ACFAS er nail trimming. members. And now these consumers are finding Summer FOOTNOTES the information they need through a new Summertime brings warm weather and interactive search feature. By viewing pho- fun outdoor activities. Use the change tos of the foot, they can click on their area of season to remind your patients of foot of concern and find a list of conditions that health and safety with the Summer 2010 would affect that area. Clicking again on any edition of FOOTNOTES, the free patient term on the list will bring up a full patient newsletter. education resource for that condition. And, •Up to date Billing-Know-How •Automated coding and Rx •275 templated chief complaints Buy PodiatryTemplatesTM today! News from the College continued from page 3 www.podbillspec.com/emr existing professionals for us to suc- In Memoriam ceed and become leaders in all med- The College recently received word of the passing of ical aspects of foot and ankle care.” the following Fellows: “Michael Stastny is so enthu- • Arnold L. Cohen, DPM, San Clemente, Calif. siastic,” responds Crawford, “he’ll ACFAS Past President, 1988–1989 most likely get the entire class • Gordon W. Falknor, DPM, Ormond Beach, Fla. to join.” • Harvey M. Kopelman, DPM, St. Petersburg, Fla. n

www.acfas.org ACFAS Corporate Sponsors Platinum Level Silver Level Merz Pharmaceuticals, LLC Pewter Level The Musculoskeletal Wright Medical DePuy MMI-USA ArthroCare Corporation Transplant Foundation Technology, Inc. Bronze Level Orthofix BioPro Officite Gold Level DJO OsteoMed Corporation L.P. DOX Podiatry Osteotech PICA GraMedica Podiatry Foundation of Extremity Medical The Podiatric Billing SBi (Small Bone Integra Foundation Pittsburgh Integra LifeSciences Specialists Innovations) KCI Synthes Corporation Smith & Nephew, Inc.

Get details about these member services at acfas.org/benefitspartners.

Prsrt Std US Postage Paid Volume 17, Issue 5 Chicago, IL This issue was mailed July 1, 2010 Permit 9711

American College of Foot and Ankle Surgeons 8725 West Higgins Road, Suite 555 Chicago, IL 60631-2724 Update is published 8 times per year by the American College of Foot and Ankle Surgeons (ACFAS), 8725 West Higgins Road, Suite 555, Chicago, IL 60631- 2724, phone 773-693-9300 or 800-421-2237, fax 773-693-9304 or 800-382-8270, e-mail info@acfas. org. Update is provided as a benefit of membership in the College and is not available by subscription. © 2010 American College of Foot and Ankle Surgeons. All rights reserved. No portion of the newsletter may be copied or distributed without permission.

The ACFAS vision is to serve society as the preeminent source of knowledge for foot and ankle surgery. Our FPO mission is to advance the competency of our members and the care of our patients.

Health Policy 8 Joint Commission Seeks Standards Comments The Joint Commission is engaged in an ongoing effort to ensure that its standards are valued by its customers and stakeholders. To assist with this, the commission is inter- ested in receiving your comments. The commission’s website now offers an online form for customers and other interested parties to comment on the value of the standards at jointcommission.org/ Standards/comment/default. The form will become a standard feature on the Joint Commission’s website, allowing for constant customer and stakeholder feedback. The commission is par- ticularly interested in knowing which standards customers and stakeholders value the most, and which they consider to be of questionable value to the delivery of quality healthcare. New Second Edition ACFAS The commission’s website has online feedback forms for all accreditation pro- Patient Education grams, the Disease-Specific Care certification and advanced certification programs, on CD-ROM and the Health Care Staffing Services certification program. acfas.org/patientCD ACFAS is represented on the Ambulatory Care Professional and Technical Advisory 800-421-2237 Committee of the Joint Commission by College member Adam M. Budny, DPM. n American College of Foot and Ankle Surgeons® Watch for more health policy updates in This Week @ ACFAS

ACFAS Update Volume 17, Issue 5