CURRENT PEDORTHICS November/December 2010 Volume 42, Issue 6 www.pedorthics.org
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November/December 2010, Volume 42, Issue 6 Time to Participate in an Interactive Case Study By Current Pedorthics Staff page 22
FEATURES Departments
12 PFA Presents Seymour Lefton Award 5 PFA Corporate Sponsors to Mike Forgrave 6 From the President By Current Pedorthics Staff 8 From the Editor 16 Best of Congress; Your Votes are In! 10 From the Board of Directors By Current Pedorthics Staff 41 Association News 24 Pediatric Pedorthics is Making a Comeback 43 Pedorthic Industry Events By Dean Mason, C.Ped., OST, BOCO, CO 44 Industry News 26 Can you be More Aggressive When it Comes 48 Government Affairs to Posterior Tibial Tendon Dysfunction? 49 Coding, Billing and By Jay Zaffater, C.Ped. Reimbursement 51 Advertiser Index 30 The Growth of Global Pedorthics By Brian Lagana 52 Pedorthic Marketplace 53 Product Reference Guide 34 Pedorthic Networking Equals Marketing By Kristi Hayes, C.Ped. 28 36 Document, Document, Document! By Dean Mason, C.Ped., OST, BOCO, CO
NAPC Photo Gallery
Pedorthic Footcare Association • www.pedorthics.org 1 CURRENT PEDORTHICS
Pedorthic Footcare Association Board of Directors Executive Committee Headquarters Staff President: Kristi Hayes, C.Ped. Vice President: Liz Chiles, C.Ped. Executive Director Treasurer: Jamie Dick, C.Ped., PT Brian K. Lagana Secretary: Jay Zaffater, C.Ped., BOC Membership Services Coordinator Directors Tristan Wood Faith Ballard, C.Ped., CO Education Director Harlon Compton, C.Ped., CO Joyce Arawole Christopher J. Costantini, C.Ped. Tamara A. Daulton, C.Ped. Education Associate Dean Mason, C.Ped., OST, BOCO, CO Lauren Kemp Ryan Nichols, C.Ped., OST Meetings and Conventions Manager Stuart L. Pressman, C.Ped., CO Jessica Cremer Rob Sobel, C.Ped. Michael D. Veder, C.Ped., CO, BOCO Sales Coordinator Vendor/Manufacturer Liaison: Stephen O’Hare Ryan Abell Medical Advisor Marketing Manager Craig Young, MD Kara Dress Editor E ditorial Staff Dennis Coyle Rob Sobel, C.Ped...... Volunteer Executive Editor Dennis Coyle...... Editor Senior Marketing Coordinator William Wargo...... Art Director Kevin Hurley Patrick Williams...... Design/Production Government Relations Directors William H. Applegate, Advertising & Services Bryan Cave, LLC Tristan Wood...... Membership Legal Counsel Ryan Abell...... PFA Symposium and Current Pedorthics Allan J. Weiner, Kelley Drye & Warren, LLP
Current Pedorthics (ISSN 1552-8111) is published bimonthly by the Pedorthic Footcare Association M arketing, Communications (PFA), 2025 M St., NW, Suite 800, Washington, DC 20036. Telephone: 202-367-1145 or & Editorial Committee 800-673-8447, Fax: 202-367-2145, Web site: www.pedorthics.org, E-mail: [email protected]. Copyright© 2010, PFA. All rights reserved. No part of this publication may be reproduced in Chair: Rob Sobel, C.Ped. any manner without written permission. Letters to the Editor and other unsolicited material are assumed intended for publication and are subject to editing. Co-Chair: Liz Chiles, C.Ped. Articles in Current Pedorthics do not necessarily reflect the opinion of PFA, its board of directors Faith Ballard, C.Ped., CO or its employees. Authors are responsible for the validity of their content and credentials. Current Tamara A. Daulton, C.Ped. Pedorthics’ use of trademarked names is done in an editorial fashion intended to benefit the trade- Jamie Dick, C.Ped., PT mark owner, with no intention of trademark infringement. Kristi Hayes, C.Ped. Subscriptions are available for $65 per year in the United States ($95 outside USA). Back copies, Dean Mason, C.Ped., OST, BOCO, CO if available, may be purchased for $10 U.S. Ryan Nichols, C.Ped., OST If you have any questions regarding display advertising or classified ads, please contact Ryan Abell Stuart Pressman, C.Ped., CO at 202-367-2332 or e-mail [email protected]. Jay Zafatter, C.Ped. Please send all product- and industry-related press releases to [email protected].
2 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
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PFA offers its thanks to these corporate sponsors whose support allows PFA to serve members and the greater pedorthic community.
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Pedorthic Footcare Association • www.pedorthics.org 5 From The President
Communication is PFA’s Main Driver to Success
The great debate about what PFA is and what As a result, the board made a conscious and it should do is a never-ending discussion. The truly collective effort with the government affairs association represents many different pedorthic committee to address the concerns. Subsequently, professionals, each with different needs based on the board sent a letter and a survey to the education, demographics, practice configuration, membership, requesting additional input. PFA etc. Nonetheless, PFA represents you, the pedorthist, collected the results, shared the information in and I personally welcome all discussion related to Orlando at the annual membership meeting and the association’s mission. will move forward with the majority vote while At the most basic level, PFA is a non-profit, still keeping in mind the public safety factors. The professional organization seeking to further the board is committed to involving members at a Kristi Hayes, C.Ped. pedorthic profession and the individuals engaged in deeper level. that profession. The board of directors is a group of In addition to government affairs, PFA also industry leaders nominated and elected into office by is actively involved in the development and the membership at large. The board is the face of the monitoring of educational programs and marketing organization and the membership is the driving force. efforts. Within these arenas, many issues can also Throughout any given year, the board will make be perceived differently by leaders and members. countless decisions it believes will help the profession. The point is that regardless of the issue at hand, Unfortunately, not every decision pleases each and the board responsibly represents all parties involved every member. It happens. It’s inevitable. It’s reality. in the profession, members or not. We have to look out for all interests, great and small, that have a stake in our profession. And while communication The board responsibly represents all needs to be improved, members must also take the time to review the provided information, weigh the parties involved in the profession, pros and cons and then actively participate with members or not. We have to look out the leadership. for all interests, great and small, that One thing we must all remember and really focus on is to communicate with each other in a have a stake in our profession. professional and respectful manner. That is the only way everyone will be heard. However, I can assure you that each decision is Remember, PFA is here for you. Likewise, members made with careful consideration. We do not base should be available for the board. You have a decisions on whims. And in many circumstances, responsibility to review the information sent to we request direct feedback from the membership you via all media outlets that PFA has created — before we move forward. PFA OnLine e-newsletter, Current Pedorthics magazine, That said, I’d like to talk about a recent decision PFA’s Web site, printed materials, e-mails and fax that created a bit of a buzz with some members. blasts. Comment appropriately, and your voices PFA recently published a letter regarding a Centers will be heard. for Medicare & Medicaid Services policy that If you have any questions or comments related the PFA was attempting to change. Some members board’s responsibilities, how to communicate with were unhappy with the letter and thought PFA the board or on any other topic, feel free to contact was more interested in defending the public than PFA Headquarters at [email protected] or me its members. In fact, PFA actually was doing directly at [email protected]. both. However, the language and method of communication were poor on PFA’s behalf and Sincerely, therefore was nearly rejected by the membership and could have been detrimental to our livelihoods Kristi Hayes, C.Ped. and profession. PFA President
6 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
From the eDitor
How Will You Navigate 2011?
As 2010 comes to an end, you will close out your volunteer leaders are there to help you. Talk to them books, analyze the profit and loss reports and begin and gain additional knowledge and help. planning for the future. Some say that long-term planning is easier said than done, especially in this Whether you like it or not, some of these issues economic climate and with the new health care will affect your business. Don’t ignore them — get reform, making it hard for a practitioner to know involved. what to do. The Centers for Medicare & Medicaid Services (CMS) will make adjustments in the Medicare system and to Get Moving the Therapeutic Shoes for Diabetics (TSD). Education standards will evolve for new pedorthic candidates. Rob Sobel, C.Ped. One of the most common mistakes a practitioner makes moving into a new year is being unprepared. Continuing education will evolve. Mainstream If you are like the majority of those in your footwear is entering pedorthics and trying to pass profession, you recently returned from the North products as “supportive,” “corrective,” “safe for American Pedorthic Congress and came away diabetics” and “pedorthist friendly.” with a worldwide view of the industry. You gained There is more competition than ever before with valuable information, techniques and skills that durable medical equipment (DME), orthotics & you may have already begun applying in your prosthetics (O&P) and physical therapy (PT) clinics practice. Sit down and record these items and update hiring pedorthists. And there is also a new influx of your marketing plan to educate your staff, referral business people marketing themselves as pedorthists. sources and patients about what you learned. All of these factors will affect your business in one In fact, make a plan to distribute this information via way or another. Research each topic and carefully e-mail, direct mail and/or “straight from the horse’s examine both sides of each issue. Don’t just make a mouth.” Be sure, though, to continue this practice choice based on your own business. Consider what throughout the year. It will rejuvenate the faith your is good for the entire profession. employees, referral sources and patients have in you. Plus, it keeps you fresh, relevant and on your game. Get Fired Up Initially, the outlook may seem dismal, but where Part of being prepared for the new year is to refresh there is turmoil, there is also opportunity. Seek your business plan. For most of us, business is up it out! As pedorthists, we are problem solvers by and down, but for some who are really focused, nature. Whether working in a clinical or retail business is way up. Regardless if you are planning setting, there are things we do to solve problems for growth or a downsize, you have to know where for our customers/patients. Bring those problem- you stand and must have a tracking system in place solving skills to your business planning. to be able to adjust and maintain your budgets in real time. This will allow you to make necessary changes throughout the year. Get Connected Network with your colleagues, including those in PFA’s leadership. Expose yourself to other points of Get Educated view. None of us have all the answers, but we can There are some hot-button issues building within accomplish great things if we work together. your profession. Today, you have a wealth of information at your fingertips. PFA publishes At the end of the day, even the best plans can fail. Current Pedorthics magazine and PFA OnLine and However, without a plan for the future, failure is consistently updates its Web site. PFA distributes guaranteed. printed materials and e-mail and fax blasts to keep you constantly in the know. Too often, though, we Stay connected to your plan, your professional hear about practitioners that didn’t read what they organization, referral sources, employees and peers then reap a very happy New Year. were sent or didn’t understand a particular topic, so rather than asking questions, they simply dismissed Sincerely, it. If you don’t read it, don’t actively participate in your own profession and are solely focused on Rob Sobel, C.Ped. your business, chances are you’re going to find Current Pedorthics, Volunteer Executive Editor yourself behind the eight ball more often than not. Marketing, Communications & Editorial In addition, PFA’s committee members, staff and Committee, Chair
8 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Lines Outlines
TRIST IA D O
P
D E N DE SI G From the PFA Board of Directors
Thank You From the PFA Board of Directors
Each year at PFA’s Annual Symposium & Exhibition, the from 1989 to 1995 and was one of 11 pedorthists invited to entire membership witnesses the pinnacle of the year’s hot the 2004 Summer Olympic Games in Athens, Greece, as part topics, continuing education efforts and marketing results. One of a delegation from PFA. LaFontsee has since treated clients particular change, however, happens completely fanfare free — like the Milwaukee Bucks and Milwaukee Brewers through the changing of the guard within the PFA Board of Directors. Orthletek, his pedorthic practice, founded in 1996. We induct new board members based on your votes. Then, “Dane (LaFontsee) was a rock when our profession stood at without any pomp and circumstance, they sit in on their first a tough crossroads — PFA was seemingly at war with itself, meeting and away they go. In addition, the board confirms the credentialing agencies and government legislation threatened slate of officers, the past president leaves the room and the new our businesses,” 2011 PFA President Kristi Hayes, C.Ped., said. president takes his or her seat and continues the meeting. “He called the membership and board members to action.” These actions assisted the current board in building and “Dane (LaFontsee) was a rock mending fences and allowed it to begin solving the profession’s when our profession stood at a major issues. It has proven to be a difficult task to find anyone who does not respect what LaFontsee accomplished during tough crossroads…He called the his time on the PFA board, said Hayes. membership and board members When asked about how the board will proceed without LaFontsee’s presence, Hayes replied, “The membership to action,” said 2011 PFA elected a good group of intelligent and committed people, President Kristi Hayes, C.Ped. who are well equipped to handle the workload. Nonetheless, his absence will be felt. He’s the strong, silent type, and I’m a We changed it up for the better and for the past several years, class clown. Together, we were good leaders. Thankfully, he the immediate past president has remained in the meeting showed me how to be a better listener and how to multiply until the end and has also served committees even after rather than divide the members. It’s a tough act to follow, leaving the board. However, saying goodbye to leaders who and I’ll do my best not to let him or the members down.” dedicate so much of their time to this organization is indeed an event. This year, the board would like to recognize and Gone but not forgotten, LaFontsee graciously accepted PFA’s thank Immediate Past President Dane LaFontsee, C.Ped. request for him to continue working on the membership’s behalf by remaining in place as the COPE committee chair for On Nov. 17, we ended an era, so to speak, as LaFontsee at least one year. He also assumes the chair position for the wrapped up 10 years as a board member and his final past president’s committee, which provides a direct line to the day as president of our great organization. He mentored board of directors for all PFA past presidents. countless people and improved PFA’s communications and the profession’s viability and longevity along the way. PFA congratulates LaFontsee on 10 years of excellent service to his professional organization and industry. The PFA board LaFontsee, a former high school standout in baseball and thanks him for everything he has done and will continue to gymnastics, served as the Milwaukee Ballet’s artistic director do for us all. ■
PFA Executive Committee
President Vice President Treasurer Secretary Kristi Hayes, C.Ped. Liz Chiles, C.Ped. Jamie Dick, C.Ped., PT Jay Zaffater, C.Ped., BOC
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By Current Pedorthics Staff
n Nov. 19, The Pedorthic Footcare Association PFA Immediate Past President Dane presented its Seymour Lefton Award — PFA’s highest LaFontsee (right), C.Ped., presents Ohonor — to Mike Forgrave, C.Ped., C.Ped. (C). Mike Forgrave, C.Ped., C.Ped.C., the Seymour Lefton Award, which is PFA’s In 1982, Forgrave was an elite Canadian track and field highest honor. athlete but was injured from overuse and miserable alignment. Fortunately, he was referred to Howard Feigel, a pedorthist and one of the founding fathers of the Pedorthic Association of Canada (PAC). He found this profession fascinating and ended up working for Feigel for the next few years. In 1985, he took his exam at Northwestern University and became a Certified Pedorthist. The rest is literally history. Forgrave started his own private practice in September of 1985 after becoming a PFA member. He then pursued his education through the Canadian pedorthic system and became certified there in 1992 and maintained his membership in both PFA and the PAC. Twenty five years later, Forgrave says he still finds the profession fascinating. He is owner and lead practitioner graduate diploma program to become a pedorthist. When of his very busy and ever growing practice, Mike Forgrave Canada went to this system, I thought there was more respect & Associates, Inc., in Kitchener, Ontario, Canada. His for our profession and an increase of practitioners because company’s motto is “a foot-by-foot approach to active living.” it was available through traditional educational channels. It mirrors exactly how he works — one patient at a time. It is not realistic to expect doctors to trust you with their In a recent interview with Current Pedorthics, Forgrave was patients without at least an associate degree. Education from very candid about his career as a pedorthist as well as his an accredited institution spurs trust and respect as one proves service to the PFA and PAC organizations. competency on higher standards.
CP: What do you see as the biggest issue facing CP: How does PFA and PAC help members navigate the profession? this issue? MF: We have some positive recognition as an allied health MF: PAC and PFA actively promote and protect our right to practice. There are many factions that would like pedorthics to care practitioner by the medical community, but there is more be nothing more than shoe salespersons. PAC and PFA monitor that needs to be done in regards to public education. The PFA what is being done to undermine our right to perform our full and PAC can only do so much — with limited funds — to scope of practice and are in regular contact with students and promote the profession and still do all the other things that members to gauge educational effectiveness. we expect associations to do. The grass roots practitioner must do more by speaking to groups in their areas about CP: What are the best benefits of being a PFA or pedorthics and advertise the profession and its pros, rather PAC member? than showcasing just footwear and orthotics. We are selling expertise and service. We’re selling real solutions. MF: One of the best benefits is networking with pedorthists from all over the continent and even the world. Some use Also, we must better educate potential students about the more footwear modifications or custom-made shoes for profession and get them excited about it. We need to gain certain pathologies while others are using more foot orthoses. more referrals from physicians. We need to increase the Another major benefit is the educational programs produced educational requirements of our pedorthists. by both PFA and PAC. Every year, they host exceptional In Canada, for example, you have to have a university degree educational programs and provide professional development (usually in a science-related field) and then a one-year post- continued on page 14
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opportunities throughout the year that are available to all CP: What special projects have you worked on in members via the Web. PFA and/or PAC in your career? CP: What has surprised you most about your MF: Over the years, I have had the pleasure of working on leadership positions in PFA and PAC? several projects for both PFA and PAC. I was part of a team that helped write “A” codes and descriptors. I was a contributing MF: I know pedorthists are passionate about their profession author to the first “introduction to pedorthics” textbook. but sometimes a pedorthist will look at how any decision During the last few years, I have teamed up with PFA Past made affects him or her personally rather than how it President Dane LaFontsee, C.Ped, to present sports injuries affects the profession as a whole. The leadership has the courses throughout Canada and the United States. I have done responsibility to enhance the profession on a national scale. several continuing education courses for PFA and am currently If you have a problem or questions on any issue, I encourage managing editor for the new Pedorthic Textbook. you to call one of your board or executive board members. The other thing that surprised me was that not all pedorthists CP: What was your experience like at the Athens in the United States are members of PFA. To me, that just Olympics in 2004? You were invited as a PFA leader. doesn’t make sense. All reap the rewards for which PFA fights, MF: Words cannot describe the experience that we had in but many don’t help fund it and that could be detrimental. In Athens. We worked very hard, but it was by far one of the most Canada, to maintain your certification, you must be a member professionally satisfying experiences I have ever had. We were of PAC, which greatly benefits the profession. working hand in hand with orthopaedic surgeons, podiatrists and chiropodists from around the world. They accepted us as CP: Please tell us your favorite story of how you’ve an important part of the footcare team. For me, it was extra helped someone through your work. special as I was unable to compete in the 1980 Olympics due to MF: A young girl was involved in a motor vehicle accident, the Canadian boycott opposing the Soviet War in Afghanistan. which left her with head injuries and a leg length discrepancy (LLD). Another practitioner (not a pedorthist) fitted her with CP: Where do you see the profession in 10 years? a below knee Ankel-Foot Orthosis (AFO) and a lift on the MF: Tough question. Our profession is rapidly changing as shoe (no rocker) and did not address the other leg at all. the landscape in health care changes on both sides of the After our biomechanical examination, we recommended two border. Our leadership must remain proactive when it comes to pairs of shoes (a running shoe and then an Oxford that she education and government affairs and members need to support could wear at school as part of her uniform) and a rocker sole the leadership. In 10 years, I see credentialed pedorthists for her LLD to allow her to properly ambulate. We provided being at the forefront of the footcare model. We are currently an orthoses for the opposite leg, which had a pes plano involved in research and are being accepted by other health ® valgum deformity and finally an Arizona AFO for her short care practitioners as knowledgeable footcare practitioners. We leg that was also a drop foot. When we delivered and fitted are seeing growth in our profession and although we still have this patient with her devices, she was able to walk with very a long road to travel, our leadership has us on the right track. little indication of her initial problem. When her mother saw her, she was crying because her daughter was walking like a CP: Anything else you feel is important for your “normal” teenager in shoes that other teenagers would wear. colleagues to know about you or the profession? CP: What advice would you give a new practitioner? MF: We are blessed to be part of the greatest profession in the world. We should never forget this or the behind-the-scenes MF: It takes time to develop a clientele. It will not knock support provided by the PFA and PAC. ■ down your door right away. New practitioners should not be afraid to go out and network with physicians as they are your most important referral source. Ask questions of people who have been in the business for years. They are more than PFA Will Never Forget Seymour Lefton happy to give you advice. At conferences, networking is a valuable reference tool so do it! Also, consider locating to an Seymour Lefton was not only one of the founders of PFA, he was underserviced area. also a driving force in the early development of the pedorthic profession and remained so for more than 30 years. Lefton CP: How have you assisted the pedorthic profession passed away in 2001, but his memory is kept alive by PFA and the profession that he devoted his life to with the profession’s achieve growth in your career? most prestigious award — the Seymour Lefton Award. MF: I like to think that all the presentations and teaching that This award recognizes outstanding service to the pedorthic I have done over the years has inspired at least one person profession by an individual. The Seymour Lefton Award is not to enter or grow the profession. Lecturing and teaching an annual award. PFA has awarded it to only 20 times since its pedorthics has hopefully helped someone glean a little more inception in 1980. knowledge or some new ideas.
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he first-ever North American Pedorthic Congress (NAPC) hall, networking with vendors. Of the attendees walking was an overwhelming success. Pedorthic specialists from the exhibit floor, 93 percent had purchasing authority for T10 nations and six continents converged in Orlando, Fla. footwear, materials and other items. The global pedorthic community showed a united front as pedorthists worldwide reinforced their mission to improve their From a micro-level, PFA decided to take its general survey a expertise, their products and their commitment to customers bit further than previous years. The association really wanted and patients that benefit from specialized pedorthic care. to know what the attendees thought. To get that information, the survey included several open-ended questions. And here The four-day event, hosted by the Pedorthic Footcare are the highlights of most and least valuable by majority Association (PFA) and the Pedorthic Association of Canada opinion and via direct quotes… (PAC), was highlighted by world-class education and many networking opportunities. PFA Board of Directors Just how successful was the event? Instead of providing personal • “The PFA membership meeting tackled the high points of opinions from either PFA or PAC, below is a summary of what all current issues the board is working on.” you, the attendees, thought about the event. It’s a compilation • “The board was transparent regarding survey results of the wide variety of comments from the NAPC survey. regarding the recent CMS issues.” • “PFA listened to the membership regarding the CMS issue A Closer Look at the Numbers and agreed to pull back based on member input.” More than 1,300 individuals from 11 countries attended. • “It is always good to get the board’s reports and be able Eighty-six percent of the attendees registered online and to provide our opinions based on your performance — 72 percent of the those who responded to the survey were good job!” pedorthists practicing in a clinical setting, 18 percent in a • “The board was front and center all the time, giving us the retail setting. chance to talk, ask questions and share experiences.” • “It’s nice to have colleagues who care about our interests.” Approximately 70 percent of those that responded felt the program fit their needs while some others felt it was either PFA’s follow-up: The PFA Executive Committee and Board of too basic or too advanced for their practices. Overall ratings Directors will communicate better with the membership by of the entire program, though, showed that more than 80 providing more surveys throughout the year on hot topics percent liked the variety, format and overall value of the and will continue to provide information on all projects, educational content and all other aspects of the Congress. regarding government affairs, lobbying efforts, marketing programs, benefits and education. Aside from education, of all the professionals surveyed, more than half spent three to five hours or more in the exhibit continued on page 18
16 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
T he Best of the Congress continued from page 16
Furthermore, Current Pedorthics, PFA’s bimonthly magazine, • “The rocker sole ‘study’ was the worst. There was no research. will devote significant space in the January/February issue, It was just opinion and retail marketing for the school. regarding the PFA Board of Directors, the structure of the The true research-based sessions were much needed. It’s organization and how it will interface in every aspect with about time, and thank you PFA for tracking down some members, the public, other organizations and the industry. real research as no one has been doing it for the industry.” • “There is not enough hands-on teaching.” Educational Programs, Break-out Sessions and • “Sessions are too long.” Speaker Quality • “Need better rounded business-practice items.” • “Session summaries did not match well with actual session • “David Nour spoke about relationship economics, and it content.” was terrific.” • “Dr. Craig Young is always a viable resource and wealth of PFA’s follow-up: The COPE committee has been notified and information. He is very dynamic.” all suggestions will be taken into consideration and pursued • “Dr. Embil’s presentation was very well done.” for future PFA symposiums. Perhaps more sessions, shorter in • The Disney Institute presentation provided valuable business length, can be achieved, and PFA may add into the mix more advice and had good energy.” practice management and hands-on sessions, giving attendees a better opportunity to learn even more. • “Dane LaFontsee’s ballet dancer show was very cool — a different spin on the norm.” Speakers will be notified that course descriptions must be • “Ryan Chang was a very good speaker.” consummate with content. PFA will continue the rating system in the course program, which outlines basic, intermediate and advanced sessions so members can continue You Said it First to make the best choices for their practices and skill levels. Below are other attendee quotes from the survey. Friday Night Social Event • “It was the best of times, it was…the best time.” • “It was a good family affair with the Disney characters.” • “It was an amazing opportunity to see pedorthics on a • “Everyone felt included in the fun.” global scale.” • “The food was served well into the 9 and 10 p.m. hours, making sure everyone was fed since it was appetizer only.” • “PFA and PAC brought their A games and really provided an incredible offering in education and marketing.” • “The relationship-building time was invaluable.” • “Couldn’t get in without my badge.” • “Talking with non-U.S. practitioners allowed me to see that • “Drinks were pricey.” much smaller countries are way ahead of the curve in this industry. We have a long way to go.” PFA’s follow-up: Full dinners and beverages are extremely • “Pedorthics in every language, color and creed.” expensive at any venue and that is why PFA has always done heavy appetizers and a cash bar as an alternative, providing • “Our leaders did a great job and their presence was felt in some form of entertainment and networking opportunities with everything I experienced. It is nice to know they care about other colleagues. In addition, it is important for PFA not to me and my practice. I appreciate each and every one of you, have liability regarding alcohol. Just as in your own businesses, and I only met three of you.” it is important to be responsible when throwing a party. • “PFA took my money and I, in turn, took everything it had to offer: PFA will continue to strive for good entertainment and food education, networking, marketing and business tips – I win!” for its members while trying to keep costs low. Because • “I will teach my staff how to ’bump the lamp!’” everyone must pay to get into the event, it is and always will • “On opening day, the buzz in the room was overwhelming. be important to present your badge and ticket at the door of People were excited and there was a lot of energy felt from the event. the speakers and the crowd. I felt that throughout the week.” If PFA did host a sit-down dinner, ticket prices would at least • “Having pedorthists from multiple countries in one place double per person and attendance would dramatically drop. is an intelligent approach to both inspire and educate the PFA’s main goal is to provide an event with substantial time profession, seeing as how the starting educational process that gives attendees a real, in-depth opportunity to socialize for a pedorthist falls short of being well rounded or a true and mingle. PFA realizes that due to the heavy schedule of education. This assisted in filling a few of those holes for the educational programming, the timing of the social event new practitioners. Kudos to the planning committees of these falls around dinner time and at certain venues, PFA is able to organizations” provide more food choices like meat stations than at others. Ticket prices are quite low compared to other organizations’ • “Thank you for such a diverse exhibition and presenter docket.” continued on page 20
18 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Leonardo Da Vinci discovered that human bodies are proportionally aligned; our physiques have predictable, mathematical relationships.
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davinci ad.indd 1 5/17/10 2:10:28 PM T he Best of the Congress continued from page 18
social events. PFA makes each dollar stretch as far as possible guestroom cleanliness and poor food and beverage services. The to give attendees the most value. hotel management has been notified of the lack of satisfaction by our members through PFA’s Board of Directors and staff. Exhibit Hall and Vendors As per PFA’s policy, locations and dates are chosen by lowest • “More exhibitors than ever before made for much more to cost, which in turn translates in PFA keeping room rates see and learn about.” under $200 per night and keeps registration costs low as well. • “Networking, networking, networking!” In addition, PFA looks for a central local for the majority of • “Some vendors offered really good deals.” PFA’s membership, which primarily consists of members from • “Congrats Verne Bintz (winner of PFA’s Vendor of the Year the North, Southeast and Midwest, with a small percentage Award). Good to see them receive an award for being a from the West. On occasion, PFA will choose a more western great vendor.” location, but in the past, the majority indicated it is not preferred. Time of year is strictly dictated by lower cost and • “Hours of exhibit hall were not right.” availability of a location’s venue as well as competing allied • “Vendors were there too early and not late enough one day.” health care conferences. Members have expressed interest in PFA’s follow-up: The exhibitors will be polled to determine their trying earlier times of year, and PFA is accommodating those preferences of hours as well as taking into account member requests the best it can for 2011 and beyond. suggestions. Furthermore, PFA’s vendor meeting will be held in the exhibit hall next year so more vendors can attend and Mark Your Calendar for the 2011 Event provide input to better serve vendor and member needs. Each year, PFA’s annual symposium evolves into a better event. If you attended this year’s event and attend PFA’s 52nd Annual Hotel and Accommodations Symposium & Exhibition, Nov. 10-13, 2011, at the Albuquerque While you indicated that you liked the warm, Orlando location, Convention Center in Albuquerque, N.M., you will see that you were not crazy about the Hilton Walt Disney World Resort evolution first hand. If you have any questions about the in general due to the lack of hotel staff friendliness, lack of 2011 symposium, please visit www.pedorthics.org. ■
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20 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 For over 70 years AGS Footwear Grou p has been here to serve you with the most complete line of pedorthic products, fitting and merchandising V erne Bintz Company aids and shoe accessories and materials.
Receives PFA’s N e w ! Arch Angels TM 2010 Vendor of the Children’s Comfort Insoles Year Award
From left to right: PFA Immediate Past President Dane LaFontsee, C.Ped., stands TM with PFA’s 2010 Vendor of the Year Award winners Ellen Bintz Meuch, chief Arch Angels Children’s Comfort Insoles of operations, Verne Bintz Company; and Verne Bintz, president, Verne Bintz are 3/4 length and fit naturally and comfortably into Company; and PFA President Kristi Hayes, C.Ped. most enclosed shoes. They are designed to make kid’s feet more comfortable while enhancing natural arch FA doesn’t present awards just to present awards.” development. These insoles contour to the developing said PFA President Kristi Hayes, C.Ped. “Rather, foot, going from a low, gentle curve in the smallest “ P the board waits until it has identified a candidate size, to a higher arch that more resembles an adult worthy of recognition. This year, we have certainly found foot with the largest size. that candidate and are honored to add them to the roll of fine TM companies that have already received this honor.” Arch Angels uses a unique triple-layer design: The PFA Board of Directors voted to present its 2010 Vendor Cushioning foam top layer. of the Year Award to the Verne Bintz Company in recognition Supportive inner core. Durable, kid-friendly foam bottom. and appreciation of the company’s dedication to, and support of the pedorthic profession and PFA for more than 30 These insoles are constructed of durable, non-toxic years, and for being a quality and long-term provider to the materials and are hand washable. professional foot care community. The company’s dedication has ensured that pedorthic practitioners have available a large selection of quality products backed by excellent customer S i z e C h a r t service to best serve their patients and clients. XS Toddler Shoe Size 6 - 8 SM Toddler Shoe Size 9 - 10 “All of us at the Verne Bintz Company are proud and honored MED Toddler Shoe Size 11 - 12 to receive the 2010 Vendor of the Year award from PFA,” said LG Youth Shoe Size 13 - 1 Ellen Bintz Meuch, chief of operations. “Please know that we YM Youth Shoe Size 2 - 3 realize it is our customers who deserve the credit for this award and who bring us our success. It has been our pleasure for more est 1932 than 30 years to provide friendly and efficient customer service AGS so that you can serve your customers, clients and patients.” footwear group Verne Bintz joins the roll of other fine companies that have received this award in the past, including Apex Health Industries 11234 Air Park Rd., P.O. Box 6444, Ashland, VA 23005 804 798 1891 800 446 3820 Fax 800 822 0180 (now Aetrex Worldwide), 2004; Acor, 2005; Esko Orthopedic www.agsfootweargroup.com Specialties, 2006; P.W. Minor, 2007; and, Drew Shoes, 2008. ■
Pedorthic Footcare Association • www.pedorthics.org 21 T ime to Participate in an Interactive Case Study
By Shane Hayes, C. Ped., COF
t the recent Pedorthic Congress in Orlando, Fla., Case Study Patient: 65 year-old female I presented an in-depth case study and pedorthists who attended were asked to respond in writing. The Osteo-Arthritis. A Dx: overall purpose was to access the general pedorthic skill level Hx: S/P Right total knee. Subsequent infection, total knee across the United States, Australia and Canada. removed and fused. Right ankle auto-fused at 15 degrees of If you were unable to attend the Congress or this particular Adduction; Slight Equinas (three degrees Plantar Flexion); Zero session, you’ll have the opportunity below to challenge Ankle ROM in Sagittal, Coronal or Transverse Planes. Right heel yourself and assess your personal skill level before reading – Two plantar locations, (posterior and lateral) heavy callused the results of your colleagues or the final outcome. Please nodules. take the time to determine how you would care for this Left ankle auto-fused straight, neutral. Zero Ankle ROM in patient before proceeding. Sagittal, Coronal or Transverse Planes. No Toe Purchase. 4th met head porokeratosis. Demographic Results – The U.S. pedorthists that responded identified themselves as being the following types of C.Peds: Gait: Extremely stiff, limited and labored. Forward progression 1. Clinical 2. Retail 3. Technical. compensated between reciprocal hip motion and left knee flexion. Bilateral hip & lower back pain. She bought extra depth, This identifies a possible trend of fewer pedorthists doing any contour shoes online; size 6D requesting any shoe modifications shoe modifications, an important component of our scope of be made to that pair of shoes. practice and a greatly needed service. Interestingly enough, Chief complaint, Left foot, 4th met head porokeratosis. the Canadians didn’t feel the need to categorize themselves as anything other than a C.Ped. (C,) as they are clinical across Rx reads “Evaluate and Treat as Appropriate”. the board and utilize more of their scope. Printed under signature is “Substitution Permitted.” In what state or province is your practice? Most of the Check all that apply to your individual practice: Canadian provinces were represented. Australian pedorthists Retail C.Ped., Clinical C.Ped.,Technical C.Ped., C.Ped.C, O&P, also chimed in with a few responses. Approximately 40 PT Other ______percent of the United States was represented. In what state or province is your practice? What portion of the appropriate treatment would you ______personally provide? Respondents were asked to answer What portion of the appropriate treatment would you personally either none, partial or complete solutions with commentary provide? as needed. None: This patient is beyond my comfort zone. I would refer it NONE — 13 percent. Even though certified, some out. If you were to refer this patient elsewhere, to what type of pedorthists would offer nothing – zero relief for the chief professional and what recommendations would you make? complaint of the 4th met porokeratosis, a pair of shoes or a referral to a fellow pedorthist or any other professional. Partial Treatment: Refer the rest to another qualified Perhaps, the enormity of problems presented by this patient professional. If you provided partial treatment, specifically what would you do? The remainder would be referred to what type of has clouded their judgment into thinking there was nothing professional and what recommendations would you make? they could do? But, there’s always something to do to make a patient more comfortable, even if it’s minimal. That’s how you Complete: I would provide all treatment necessary. build a practice and stay ahead of your competition. Some Specifically, what treatment would you provide, including your would refer them back to the referring doctor for further biomechanical reasoning? consultation, which is a good way to shoot yourself in the foot with the doctor.
22 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 One call. One Source for all your PARTIAL — 25 percent. These pedorthists agreed that some sort of accommodative device was appropriate for the 4th met porokeratosis. None mentioned the nodules on the opposite Continuous Fiber foot. Ten percent would insert a small right heel wedge for the equinas and another 10 percent identified the Leg Length Reinforced Thermoplastic Discrepancy (LLD). Seventy-five percent checked the fit of the previous shoe purchased and made other recommendations, (CFRT ®) needs. including commercially available rocker shoes. TL-2100 COMPLETE — 62 percent. About half of respondents The premium Graphite Orthotic correctly identified the need to address a LLD, considering the material. #1 for comfort and right total knee was removed and fused. The rest overlooked #1 for functional control. this critical detail. (The LLD was left out of the case study NOW with rounded heel. description to be able to assess respondent’s evaluation skills and attention to detail.) Some felt they could move the fixed ankle deformity with a wedge, while others felt it appropriate to use a functional orthosis to attempt rebalancing those same fused ankles. Ninety percent recommended an accommodative orthoses, while 67 percent added lateral heel flairs. The 33 percent who missed the flairs, wanted more information from other medical professionals. TL-SILVER Virtually this entire group felt some sort of rocker was appropriate, with very little agreement as to which type. An acrylic thermoplastic Only a few mentioned accommodating the right heel nodule. fiberglass composite material. Fifty percent would address the right foot equinas. Most of High strength, increased this group omitted checking the shoe fit of the previously control for deeper cups. purchased shoes, opting to address a majority of the 18 modalities necessary to make this patient comfortable. J-TURF CUTOUTS, SHEETS & Final Modalities by Shane Hayes TL-SILVER SHOE SHANKS The patient’s stiff, limited and labored (robot like) gait with An acrylic thermoplastic reciprocal hip motion undoubtedly contributed to her lower fiberglass composite back pain in spite of her chief complaint being the Left 4th material. met porokeratosis. The lack of a right knee clearly created a LLD requiring a lift. Fit of previously purchased shoes was verified. This shoe has a 1" heel height. Putting the right shoe on and removing the left shoe, the Iliac Crests were level making a 1" heel and sole lift necessary. Even though the right adducted foot had auto-fused at the ankle, with the knee also fused, she had no choice but to circumduct at the hip in order to make any forward progress. BAMBOOLON J-GLAS She was forced to medial heel strike. Mid-stance weight was With our popular Bamboo transferred to the base of the 5th met, and toe-off was around Neolon top cover in a 3mm. the 3rd toe, essentially a C-shaped gait. The reciprocal gait Bamboolon is anti-microbial, caused lateral sway so to extend the lever arm, lateral heel comes in Men’s and Women’s flairs were used bi-laterally. sizes. The lift and flairs helped stabilize but issues of momentum and stabilization throughout the complete gait cycle still existed. A bi-lateral, straight rocker from heel to toe would destabilize her considering the right foot adduction and the reciprocal gait. For pricing and shipping What to do? Both heels were slightly beveled for heel information call JMS strike; the mid-foot was essentially flat with just a hint of today at 800-342-2602 rocker. The right gentle toe rocker was beveled to match the or visit us at adducted gait with the left being straighter. www.jmsplastics.com continued on page 32 Produced in cooperation with Performance Materials Corporation
Pedorthic Footcare Association • www.pedorthics.org 23 Pediatric Pedorthics is Making a Comeback
By Dean Mason, C.Ped., OST, BOCO, CO
verything old is new again, and so it is with pediatrics in our profession. The recent North American EPedorthic Congress in Orlando, Fla., featured a three- person panel with Jonathon Markell as the moderator. It’s worthy to note that Markell’s company has been making pediatric corrective footwear for many years. Dr. Jay Albright, an orthopedic surgeon who practices pediatric orthopedic sports medicine at the Orlando Regional Medical Center, presented the Ponseti method of correction of Talipes equinovarus (club foot). He said that 80 percent of all club foot cases are in Third World nations. There are only about 2,400 cases in the United States those fitting children’s footwear. At the outset, all that was out of 100,000 cases worldwide. done was shoe therapy. He reported that children’s footwear is making a comeback. It stands to reason that children’s The treatment still stirs controversy in the medical feet come in sizes and widths, too, and these need to be community. The Ponseti method consists of gentle accommodated lest the footwear create a deformity in this manipulation of the foot and ankle, serial casting, a most malleable of feet. percutaneous heel tenotomy and up to four years treatment in a Denis Browne splint. The success rate is nearly 100 As modalities progressed, accommodations such as Thomas percent when all stages are completed. Heels, wedges and bars were added to shoes; therefore repositioning and protecting the foot from adverse motion, Albright also showed several slides screening the progression redirecting weight bearing and applied force to influence of a case as the child grew and the casts maintained the ground reactions. He presented a case of a high school football corrected position of the foot and talus. player who had cavus type feet where the arch became higher and higher. One day while in school, he had an episode where The second panelist was Caspar Ozinga C.Ped , C.Ped (Au). his bowel evacuated, he fell and was taken to the hospital. He A significant part of Ozinga’s practice is pediatrics. Some was diagnosed with a spinal cord tumor. The moral here is to pedorthists have seen a decline in this market, which is be observant and have irregularities checked out. troubling; however, all the panelists were encouraged that the newer breed of doctor is rediscovering the tried-and- Children’s pedorthics have always been an essential part of our true methods of treating children. For many years, pediatric practices. For many years, new theories in the treatment of problems have been left to self-resolve. pediatric foot conditions have been tried and most have failed. The return to the more tried-and-true modalities is a refreshing Ozinga discussed the methods of treating conditions such change. It does come with a greater challenge now as cosmesis as Cerebral Palsy (Hart Walker, AFO), Down’s Syndrome and compliance are more of an issue than 50 years ago. These with the small and very wide foot and metatarsus adductus panelists are dedicated to pediatric treatments and are great (straight and reverse last shoes). It was interesting to note resources when the pediatric patient comes to you. This is that toe walking has a neurological cause and is treated with also an opportunity for pedorthists to work with pediatricians an intervention of physical therapy along with pedorthic and orthopedists to reintroduce pedorthic modalities into modalities. He recommended searching for “foot posture their treatment of pediatric foot conditions. ■ index” to gain insight into significant planus deformities. There were several other conditions that were discussed along with their respective pedorthic treatments. Dean Mason was first certified in 1998, following preparatory work at Ball State University, Medical College of Wisconsin and X-tra Depth The final panelist was Dennis Janisse, C.Ped., who has been University. He was later certified as an orthotist in 2002 by BOC and treating pediatric problems for most of his career. Pedorthics was certified in 2007 by ABC. Mason started North Shore Pedorthics as a originated in the shoe repair industry in conjunction with C.Ped. in 1998.
24 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
is an eversion correction made to the posterior plantar medial calcaneus of the positive cast. This creates a unique varus posting of the heel cup, which creates a supination moment across the subtalar axis. An intrinsic correction Can you be that is formulated by McGuire with a 10:2 ratio, with every two degrees of eversion correction needed, 10 degrees of inversion is applied at the rear foot. The orthotic is completed with a deep heel cup; 3/8" heel lift, longitudinal arch and balanced forefoot and high top shoes were also suggested. Both Munday and Houghton said that this was far more More correction for PTTD than they had ever thought to use in their practice. McGuire was able to expound upon the accepted PTTD Age g r sSIv information and gave the attendees a lot to think about. Houghton further stated, “I didn’t really think of PTTD When it Comes to correction in all three planes. Whatever correction you make in one plane will always affect the other two.” McGuire continued on and in reference to tri-plane consideration, he said that ultimately the posterior tibial Posterior tendon is just a minor player in the chronic collapse of the hind foot. His focus is on the slow chronic ligament damage created over time. The mid tarsal joint is placed under stress from PTTD caused by rearfoot pronation T ibial Tendon and forefoot supination. In most cases, the patients are 6-to-1 women over the age of 50 and are unilateral 72 percent of the time. McGuire attributes this mainly to the female long narrow foot, obesity and microvascular issues. Dysfunction? These conditions and chronic stress overload lead to the pathomechanical flatfoot. By Jay Zaffater, C.Ped. The lecture also focused on the axis of the subtalar joint being a mean and not a standard. McGuire’s research shows that there are eight to nine different types of subtalar hen Dr. James McGuire, DPM, PT, C.Ped., joints. This study was done with cadaver assessment from FAPWCA and director of the Temple University anatomists around the world. W Wound Center, decided to lecture at the 2010 Not only do you have to acknowledge in what plane the North American Pedorthic Congress, he was unaware of how deformity is occurring but also distinguish and account many people would attend his session on Posterior Tibial for the low to high axis of the subtalar. According to Tendon Dysfunction (PTTD). McGuire, a frontal plane deformity is low axis, a sagittal To say it was a well-attended lecture is an understatement. plane deformity is medium axis and a transverse plane The large number of attendees showed that PTTD is a deformity is high axis. When accounting for the changes common patient indication in many pedorthic practices. from deformity and anatomical differences, the orthosis must reflect the individuality component to offer the most pain- Julie Munday, C.Ped (C), with Sole Decisions located in free correction without the continued adjustments usually London, ON, Canada, was one of these attendees. associated with custom functional orthotics. “PTTD is common in my practice and I’m shocked at how McGuire’s easy manner and extensive knowledge on the aggressively Dr. McGuire and his team approached the degree subject of PTTD made the session not only educational and of eversion correction applied to their orthoses,” said Munday. informative but a well-received addition to this year’s North American Pedorthic Congress. ■ Mark Houghton, C.Ped., from A.M.A Medical in Fort Myers, Fla., made a similar comment about the Kirby Skive technique that seems to work for McGuire. Jay Zaffater graduated from Louisiana Tech in 1989 and taught high school five years. He currently works as the clinical marketing director for In McGuire’s description of the Kirby Skive, he elicited an ArTex Medical, Inc., in Shreveport, La. He has been a Certified Pedorthist attendee reaction bordering on a gasp. The Kirby Skive for six years and currently serves on the PFA Board of Directors.
26 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
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1
5
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All names listed left to right.
1. Dana LaFontsee and PFA Immediate Past President Dane LaFontsee, C.Ped., enjoy the Friday night social event with PFA President Kristi Hayes, C.Ped.
3 2. Friday night social event carried a Disney theme complete with Mickey Mouse in his pirate garb. Pirate Mickey entertained the crowd and had his photo snapped with many of the guests.
3. Congress attendees find time to chat during one of the many educational sessions throughout the four-day event.
4. A pedorthic professional gains valuable information from one of the NAPC’s vendors in the exhibit hall.
5. Trading pedorthic secrets, sharing tips and giving product advice was a common occurrence in and out of the exhibit halls.
28 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 6 7
6. Ahoy! A swashbuckling buccaneer entertains a crowd of attendees at the Friday night social event.
7. PAC’s President Graham Archer shares his success and the joy of partying with pedorthists with his darling baby and family in Orlando.
8. In addition to Mickey Mouse and a buccaneer, guests also enjoyed watching this scallywag wander around the party.
9. The lively environment during the Friday 8 9 night social event made for easy networking.
10. The warm Florida weather and Disney location allowed many pedorthic professionals to bring their families for a combined vacation and to obtain education.
11. On the dance floor at the Friday night party, this energetic professional showed her versatility and tackled the hoola hoop.
12. Members of the PFA Board of Directors — Jamie Dick, C.Ped., PT; Tammy Daulton, C.Ped.; Faith Ballard, C.Ped., CO; Christopher J. Constantini and Liz Chiles, C.Ped. — take a much needed break from 10 their meetings.
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Pedorthic Footcare Association • www.pedorthics.org 29 T he Growth of Global Pedorthics
By Brian Lagana, PFA Executive Director
he recently completed North American Pedorthic regional memberships. In addition, a fourth organization Congress in Orlando, Fla., jointly produced by based in Europe supports the orthopedic shoe technician. the Pedorthic Footcare Association (PFA) and the T Founded in 1973, the Internationaler Verband der Orthopadie Pedorthic Association of Canada (PAC) was not the first collaborative effort between the two organizations to take Schuhtechniker (the International Organization for Orthopedic pedorthics to a global audience, but it was certainly the Shoe Technicians or IVO) is a Europe-centric federation largest and most successful. of county-level organizations supporting orthopedic shoe technicians. Though based in Europe with a European majority Five years in the planning with a joint PFA-PAC planning membership, the organization also boasts membership from committee, the Congress resulted in attendance of more Japan, as well as the APMGFA and, most recently, PFA. than 1,300 individuals from 11 countries and more than 130 exhibiting companies, as well as world-class education IVO provides professional development and advocacy to its and networking. members similar to PFA, PAC and APMGFA. IVO provides a triennial Congress – the next, hosted by the APMGFA, will be Two earlier conference efforts between PFA and PAC in the held in 2012 in Sydney, Australia. late 1980s and early 1990s helped to establish the foundation for what has grown from a North American phenomenon into IVO also seeks to promote a uniform orthopedic shoe a global allied health care profession. Pedorthic educators terminology; advance awareness of orthopedics with from amongst the PFA and PAC memberships have helped specialized practitioners, paramedical organizations and other to not only advance the awareness about pedorthics, but also national and international organizations related to the field; have developed groups of educated practitioners around the align the training and examination system for orthopedic world, most notably in countries in Asia and Africa. shoe specialists, at least in Europe; promote cross-border contacts in the orthopedic shoe field and more. From the start of pedorthics in the late 1940s and early 1950s, PFA, then the only organization supporting the pedorthic Pedorthics remains a small allied health care profession relative profession, was a natural draw for individuals practicing in the to other fields. However, the awareness building efforts of PFA, United States and eventually around the world to coalesce and PAC, APGMFA and IVO — through education, networking, seek support for their professional development, continuing standards setting, communications and more — are working to education, advocacy needs and more. firmly establish pedorthics and its equivalent in an increasing number of countries. With the growing number of pedorthic Now, there are three organizations around the world — PFA, and orthopedic shoe practitioners around the world, it is only PAC, and the Australian Pedorthic Medical Grade Footwear a matter of time before the public, insurance companies and Association (APMGFA) — specifically supporting the world’s the various governments and agencies begin to take notice pedorthic practitioners. PFA is still looked at as the global and recognize pedorthics and its equivalent, as has been done membership organization and PAC and APMGFA attract in the United States, Canada and Australia. ■
30 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6
T ime to Participate in an Interactive Case Study continued from page 23
The accommodative orthosis on the right included a three- A sincere thank you to all who participated and were willing degree wedge, bringing the floor up to meet the heel for to share their level of expertise with their fellow pedorthists. the slight equinas. It also included cushioned divots for the Our profession is a life-long learning experience. None of us posterior and lateral heel nodules. The left accommodative are ever too young, too old or so experienced that there isn’t orthosis included a metatarsal pad and a cushioned divot for room to grow or improve upon our skills. More case studies the 4th met porokeratosis. like this will hopefully tax our brains, cause us to be more inquisitive and improve our skill level. On follow up, no adjustments were necessary so the above formula was duplicated into a second pair of new shoes. The participants’ diversity in their types of practice represents a variety of skill sets. The best part of this case study is that Final Modalities Provided this type of complicated patient could find a fair amount Right Left of relief from the vast majority of pedorthists across the Heel and Sole Lift 1" Lateral Heel Flair continent. The cream of the pedorthic crop rises to the top through keen observation and evaluation skills coupled with Lateral Heel Flair Slightly Beveled Heel the ability to provide all the modalities necessary to meet a Slightly Beveled Heel Flat Mid-foot with hint of rocker complex patient’s needs. ■ Flat Mid-foot with hint of rocker Straight Gentle Toe Rock Adducted Gentle Toe Rock Accommodative Orthosis Shane Hayes, a Seymour Lefton Accommodative Orthosis Met Pad award winner, is a Certified Cushioned Divot X2 Nodules Cushioned Divot 4th met Porokeratosis Pedorthist and Orthotic Fitter Shane Hayes would like to thank Three-degree heel rise in orthosis based in Seattle, Wash. He Brooks for sponsoring the is published in the Journal of participation prizes, which are on their Bi-Lateral: Checked shoe fit of 6D, provided additional new American Medical Association way to all identifiable participants. shoes, gait analysis. and is a former president of PFA.
Disney Theme a Hit at the 2010 NAPC
Results from the 2010 North American Pedorthic Congress attendee survey say it all:
• “Friday evening event awesome. Hats off to event sponsor Vittoria Phoenix.” • “Fun evening by the pool and really well done. All my colleagues were impressed and really enjoyed the evening.” The Friday night social event – Disney at the Hilton – delivered on the fun, excitement and networking opportunities the planners had hoped for! Adults and children were amazed by the pirate-themed event, which included a pirate cove, pirates, shipmates and a host of other Disney characters. The pool patio at the Hilton Walt Disney World Resort was jammed with pedorthic professionals from around the world listening to music spun by a professional DJ, enjoying the networking opportunities and having a bite to eat and drink. A tradition of both the PFA and PAC symposia, the Friday night social event is a light food and beverage reception with entertainment designed to provide networking opportunities in a more casual setting. ■
32 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 More Widths. More Sizes. More Comfort. More A5500 Coded Styles.
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By Kristi Hayes, C.Ped.
ealth care practitioners that hung out their shingle Once you look at the factors involved in the practice decline, in the sixties and seventies have been through a lot. you can explore various remedies. They enjoyed the golden years of private practice, H Begin by developing relationships with young practitioners endured the painful intrusion of managed care and have survived the somewhat tumultuous aftermath. They are entering your community. They need seasoned professionals strong, but some are dismayed and disenchanted with their to break into the medical community and to support them current position. Many have reached a time when they in the community at large. New referral sources need to expected to take it easy, yet they find themselves working know specialists they can send their patients. They will gain harder than ever. Others are concerned about a continued confidence in your ability to treat their patients from both decline in their patient base. With all their experience and a personal and a clinical point of view once you open the eagerness to work, their practices are still dwindling and they lines of communication and strengthen the relationship. Younger specialists need to know as much as they can about don’t know what to do. pedorthists and other health care professionals that serve The same has been true in the pedorthic profession. With the community, especially those that have been in practice the lack of a complete education for some, lack of practical for an extended period of time. They will appreciate your experience for others and the ever-changing world around us, knowledge of the general community and the politics of the many things influence survival and growth. Here are a few immediate medical community. suggestions to help jump start your practice. Look to the medical staff office at your local hospital for a First, take a look at why you might be experiencing a roster of new staff members. Develop an approach to become dwindling practice. There are likely to be a number of familiar with the new doctors in town. If there are only a few, reasons. Often, the referral base you currently depend on your job will be simple. If there are many, you will need to is the same one as 10, 20 or even 30 years ago, but not set a goal on how many you want to contact each month and all of those physicians or other referral sources are still what criteria you will use to prioritize the list. around. Some have relocated, and others have retired. At Meet with each physician you have identified, whether the same time, word-of-mouth referrals decline as your own specialty group or primary care. Invite them to a business patient’s age. You will lose some due to death; others move lunch or perhaps to a local medical society meeting to out of the area or stop seeing you for various reasons. Add introduce them to other members of the medical community. to this list the patients that have switched to practitioners Explore his or her personal and professional interests and that bill insurance plans and the up and down economy. begin to develop a relationship. The shrinkage becomes obvious. Independent practices are particularly vulnerable because some health care plans will Stay actively involved in hospital, clinic, nursing home and only contract with group practices and overhead expenses retirement center activities and committee work. Use this can be daunting for the small practice. as a source to work in tandem with new referral sources.
34 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Committee involvement can pay big dividends with even a small amount of your time. Therapeutic & Diabeitc shoes It is also very effective to tap into the media. Contact the health and medicine editor of your local newspaper. Inquire PDAC Approved about a possible byline and invite the editors to call you for Custom Orthotics an interview whenever a hot health care topic related to foot care is ready to hit the news. Suggest that you can become a for Patients with diabetes & Foot pains regular or bimonthly department — Ask the Pedorthist — as 1-888-937-2747 an example. It is also a good idea to develop a practice business portfolio. It might include a black-and-white press photo, your curriculum vitae, a copy of any recent bylined articles and a list of areas where you have specialized expertise and PDAC Code A5513 knowledge. You might also include a list of lectures you are willing to conduct for community groups or literature on pedorthics that you can obtain from PFA. Such a portfolio is good for contacting both the media and community organizations. The business portfolio can be helpful in opening doors to get on a radio talk show. It is easy to think that they won’t + be interested, but they will most likely welcome health care professionals who have something to say. It’s important to be prepared before you make the contact. Decide on a couple of relevant and current health care issues that you can speak $75/3 Pairs about. Then set up an appointment or a telephone conference to discuss. If it is a telephone conference, you should send $35/ 1 Pair your business portfolio in advance. If it is a meeting, bring it with you. Remember to be as personable as possible. Free Shipping*Free Foam Boxes*Great Value Additionally, you can contact PFA for assistance on some good talking points to promote both your practice as well as the profession. Diabetic Shoes It can also help to encourage your practice manager to be active in community organizations. Pay his or her fees to join W/3 pairs of Custom Orthotics a local service group as your representative and to volunteer you as a program speaker. The most important asset in your practice is the people. A5500 This includes you and your staff, as well as the patients and referral sources. Be sure your service is superior and that you and everyone working for you are committed to making patients and referral sources feel important. Do everything you can to take care of and attract patients Plus of the predominant age ranges in your area. Above all, be personable. That’s what patients really want and that’s what they will talk about among their friends and colleagues. It’s your practice, so make the most of it! ■ A5513 Kristi Hayes is a second-generation Board Certified Pedorthist, who has utilized her unique skill set in multiple practices settings on the $120/Package West Coast for more than 18 years. As a pedorthic business consultant, she travels across the country to improve practice management in all , the Right Choice for the Right Reasons! aspects for small- and medium-sized businesses. Her specialties include Apis marketing, strategic planning and training personnel. She has served is the registered Trademark of Apis Footwear Company the Pedorthic Footcare Association membership as a board of directors member and committee chair since 2006 and is currently the president.
Pedorthic Footcare Association • www.pedorthics.org 35 Examination and Treatment Records The purpose of maintaining documentation is to have the most complete record of treatments used for a particular patient. The examination is the key to determine modality and its efficacy. Only after the empirical evidence is gathered can it be synthesized and transformed into a suitable solution. The gathering of information begins with the initial call for an appointment. The person who schedules appointments begins with the reason for the call. In most cases it is to fill a prescription from a physician. This gives an indication of what the practitioner will be treating. Knowing that the patient has a diagnosis of plantar fasciitis, you can begin gathering information about their gait from the moment you meet in the waiting room. It is always more beneficial to see the gait under normal conditions rather than in a setting where the patient knows they are being watched. Pay attention to clues that are revealed without your patient’s knowledge. An examination form is pretty standard in the profession, though there are themes and variations. As a rule of thumb, it is far better to have a list of signs and presentations to look at than it is to guess. Call it a memory trigger. A foot will be normal, cavus or planus. These three are the only possibilities. Yet, one can have a cavus type foot with an everted heel. Impossible you say? Not really. Add tibial varum to the anatomical profile, and poof, a cavus foot with everted heel. The form used in my practice is four pages and is divided into four sections. The first section is general information. This page contains patient name, physician information, practitioner, some baseline conditions such as diabetes melitus or edema, blank areas divided into prior history and current condition, and a section for why they are seeking help. Page two has diagrams of the dorsum and plantar surfaces of Document, the feet and common pathologies. The diagrams are to note callused areas where “x” marks the spot and ulcerated areas where “o” marks this spot. The diagrams have been used to Document, show amputated areas or the location of a particular pathology. The pathologies and conditions section cover many of the common problems. The line item is followed by “R, L, or BL” Document! with space for writing notes and additional conditions.
By Dean Mason, C.Ped., OST, BOCO, CO Page three is a biomechanical examination. This page is concerned with the positioning of the foot in the cardinal body Editor’s note: This the final installment of a two-part series that planes and the ranges of motion for various articulations. outlines best practices related to documentation. The final page is the working model for treatment. The top of the page has a more extensive note section followed by ocumentation is critical to every aspect of the instructions for fabricating the orthotic device, shoe selection pedorthic profession. Without proper documentation, and any modifications that are indicated. Dyour practice will suffer and so will the care you The examination report gathers the required information and provide your patients. The first installment (see the May/ puts it in a very easy to use format. The goal is to recreate in June issue) covered intake information, insurance information your mind the encounter. and billing records. This final installment will go over examination and treatment records as well as insurance and Information gathering is the key to successful management. billing documentation. It is especially true for an initial visit. It is amazing how much
36 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 you can gather from a five-minute conversation. It’s also report form and use it as a standard procedure. Word amazing that it can take more than an hour to document a processors are perfect vehicles for reporting. Abbreviations 15-minute visit. can be programmed to print entire sentences and paragraphs. For instance, when the letters “f “and “c” are typed together, Ask probing questions of your patient: “How long have you the program produces: “Impressions of the feet were obtained been diagnosed with diabetes? What are your blood glucose using impression foam with the feet placed in the subtalar levels? What is your hemoglobin A1C number? What caused neutral position.” this problem? How long have you had it? Is there anything you do that makes it better or worse?” This is the place where your diagnostic skills are put to the test. Taking what appears Now wasn’t that easy? to be obscure bits of information and piecing them together is Exam documentation also includes a written lab order why we train. This is where the knowledge of pathology and for the fabrication of the orthoses. Clear instructions are pathomechanics fuse to provide a solution for aching feet. necessary for producing the kind of device that you envision. This is especially true if someone else is actually doing the It is important to ask about other attempted treatments and fabricating. A separate form is used to delineate modifications their outcomes. We are all familiar with the “bag of non- on shoes. In my practice, I use a “job ticket” sleeve that working orthotics” that a patient brings to their appointment. It is important to know what was done and when. It will help is clear plastic on both sides. This is found in many office you to formulate a better treatment plan. supply stores and is commonly used in auto repair shops. It allows the orthotic order and the shoe modifications order to After the examination and the appointment are finished, be seen without having to rifle through pieces of paper. An it’s time to go back and report on what was done. Written added bonus is that it is impervious to plaster, glue, thinner records are important. Memories can become fuzzy, but the and a host of lab conditions printed word endures. Formulate a boilerplate examination continued on page 38
Pedorthic Footcare Association • www.pedorthics.org 37 Document, Document, Document continued from page 37
Once the orthoses, shoes and modifications are dispensed Many offices use electronic documentation and some use to the patient, it’s time again to write. This time it is a report a combination of written and electronic. Just remember that of the trial fitting and final disposition of the case. Note any all your records must be complete, accurate and are subject changes you made during this process such as grinding down to Health Insurance Portability and Accountability Act an area on the orthosis or fitting problems with the shoe. (HIPPA) regulations. Adjustments are common, and the patient needs to be aware that we may be required to “tweak” it just for them. Insurance and Billing Documentation Follow-up visits also require documentation. There are Third-party payers are a fact of life for health care many ways to perform this documentation. Subjective, professions. It is important to maintain accurate billing and Objective, Assessment and Plan (SOAP) notes are one way. payment records. The process begins with the encounter. An There should always be blank pages at the end of the chart encounter is the in-person visit of patient and practitioner. for noting results of phone calls or office visits. The use of Many practices use some form of encounter form that gives a micro cassette recorder is very helpful in recalling details. identifying information about the patient, the diagnosis, Just make sure to transcribe the spoken report to paper. the procedure codes used, place and units of service and
Frequently Asked Questions Q: Is a CMN required for diabetic shoes? filed, which has the potential of a medial about Documentation Prior A: Therapeutic shoes do not require a necessity denial making it supplier-liable. CMN; however, they do require a certifying This business decision is recommended. to DME Claim Submission physician’s statement per the Local Coverage Q: When a patient is in a nursing home of Relevance to Pedorthists Determination/Policy Article. and they request shoes and orthotics for a As collected and answered by the Jurisdiction Q: Does the advance beneficiary notice diabetic patient, the nursing home would in Region D Durable Medical Equipment (ABN) apply to statutorily excluded items? be billed for those items under the skilled nursing facility (SNF) billing requirements. Medicare Administrative Contractor A: It is voluntary if you want to execute an Do we have to provide them with an ABN? (Jurisdiction D DME MAC.) ABN but not necessary. A: The SNFABN (CMS-approved model Form Q: Can you bill back from the date of the Q: Who can give the ABN to the beneficiary CMS-10055) is for use with SNF prospective verbal order even if the physician does not and explain it? payment process services (PPS). This form get the signed order back 30 days later? A: As the supplier, you can. satisfies the requirements under Limitations A: The date of service on the claim would of Liability (LOL) for advance beneficiary be the date the item is dispensed. But, the Q: Does an authorized representative need notice and the beneficiary’s agreement written order must be received prior to billing, to make notation of their relationship to the to pay. The use of any other notices or of or the EY modifier must be used on the claim. patient on the ABN form? modified SNFABNs may be ineffective in Q: Can physician signature stamps be used A: Yes. protecting users from liability. The SNFABN on a detailed written order? I know there must be prepared with an original ,at least Q: If an ABN is returned signed and dated needs to be a signature on a certificate of one patient copy, a SNF copy containing but no option was indicated, can the medical necessity (CMN) form, but what the signature of the patient or authorized about the detailed written order? supplier call the patient to ask which option representative, an attending physician they want? A: Signature stamps can no longer be copy and (when necessary) a Medicare used for any medical record documents, A: No. This section needs to be completed by contractor copy. SNFs may produce SNFABNs Certificate of Medical Necessity (CMN)/ the beneficiary. using self-carboning paper and other methods of producing copies, including Denials Information Form orders. For more Q: If a customer knows the item is not photocopying, printing and electronic information, refer to Special Edition 0829, covered, do we have to have an ABN with generation, but they should conform to the Change Request 5971 or MedLearn Matters option 2 checked, or can it simply be a Form CMS-10055 design. Article 6261. cash sale? Q: When we receive a verbal order, does A: If the item is a non-covered item, it is Q: Is it a good idea to get an ABN form the written order from the doctor’s office suggested to have the ABN signed and dated signed in any case before any orders need to have the same service date as the by the beneficiary indicating that they do are filled? verbal order? not want you to bill Medicare. This will help A: Blanket or routine ABNs cannot be given. A: Yes, it needs to reflect the start date of the to prevent them from turning around at a ABNs may be given at times of non-coverage verbal order. later date and saying they want the claim due to over utilization, for example.
38 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 charges. The encounter form may be a preprinted blank form Many practices use a billing service. This takes a lot of the or a “superbill” that is generated from patient accounting difficulty out of the process of submitting claims, but it does programs. Data entry on the appropriate claim form or come at a price. Medicare uses an electronic system that submission software begins with this encounter information. was just recently upgraded. Claims are submitted over a secure phone line, and remittances are sent using the same HCFA 1500 is the standard paper billing form. With the arrangement. Most insurance companies have interactive voice adoption of the NPI numbers, the form was changed to response (IVR) units where you can place a phone call to trace include this information. Not every insurance company your claim and find out information about your patient. requires that all boxes are completed. Every practice has a card file, binder or notebook with the individual quirks and Once the claim is processed and paid, the explanation of requirements for the respective insurance. Most of these medical benefits (EMB or EOMB) is sent along with your references come from returned and rejected claims. The remittance. This form explains what was paid, how much was insurance companies generally don’t tell you how the form paid and references any deductibles, co-payments or other needs to be completed, but they will let you know when you financial information. Contracted practices agree to accept a do it wrong. continued on page 40
Q: What do you use on an ABN if you are In instances where the items are delivered within one year of the order on file. However, not supposed to use “May not be covered directly by the supplier, the date the the supplier’s records should document the by Medicare”? beneficiary received the DMEPOS supply shall reason for the replacement. A new order is A: You need to enter a specific reason that be the date of service on the claim. required for the replacement of any shoe. A new order is also required for the replacement Medicare may not pay in terms that the Q: Does the supplier have to have medical beneficiary understands. Simply stating that of an insert or modification more than one records in the file prior to submitting the year from the most recent order on file. the item/service “may not be covered by claim with a KX modifier? Medicare” is not acceptable. A: The definition of the KX modifier indicates The supplier must obtain a signed statement from the physician who is managing the Q: How many years does an ABN need to be that “requirements in the medical policy patient’s systemic diabetes condition (i.e., kept on file? have been met.” For purposes of Medicare’s Therapeutic Shoes for Diabetics (TSD) the certifying physician) specifying that A: All documentation should be kept in your benefit, it is expected that the patient’s the patient has diabetes mellitus, has one files for seven years. medical records will reflect the need for of conditions 2a-2f listed in the TSD local coverage determination’s (LCD) related Q: Because of our type of practice, we the care provided. The patient’s medical policy article, is being treated under a do not deliver to the home or through the records include the physician’s office comprehensive plan of care for his/her mail but directly to the beneficiary at our records,hospital records, nursing home diabetes and needs diabetic shoes. The practice location. What type of proof of records, home health agency records, records certifying physician must be an Medical delivery do we need to maintain to be in from other health care professionals and Doctor or Doctor of Osteopathy and may not compliance? test reports. This documentation must be available upon request. be a podiatrist, physician assistant, nurse A: Suppliers may deliver directly to the practitioner or clinical nurse specialist. beneficiary or the beneficiary’s designee. An An order for each item billed must be The Statement of Certifying Physician for example of proof of delivery to a beneficiary signed and dated by the prescribing Therapeutic Shoes form is recommended. is having a signed delivery slip, and it is physician, kept on file by the supplier and Whatever form is used, it must contain all of recommended that the delivery slip include: made available upon request. Items billed the elements contained on the recommended before a signed and dated order has been • The patient’s name; form attached to the LCD. This statement received by the supplier must be submitted must be completed, signed and dated by • The quantity delivered; with an EY modifier added to each affected the certifying physician. A new certification Healthcare Common Procedure Coding • A detailed description of the item being statement is required for a shoe, insert or System (HCPCS) code. delivered; modification provided more than one year If the prescribing physician is the supplier, from the most recent certification statement • The brand name; and a separate order is not required, but the on file. • The serial number. item provided must be clearly noted in the The International Classifications of Diseases The date of signature on the delivery slip patient’s record. Code System (ICD)-9 code that justifies the must be the date that the DMEPOS item A new order is not required for the need for these items must be included on was received by the beneficiary or designee. replacement of an insert or modification the claim.
Pedorthic Footcare Association • www.pedorthics.org 39 Document, Document, Document continued from page 39
Documentation is time consuming, yet necessary part of what we do. Finding ways to streamline the process can be a challenge, but one worth taking. “Pearls” are cultivated each time we find a new and better way to maintain our documentation.
certain amount for services and any decrease from the billed a challenge, but one worth taking. “Pearls” are cultivated amount is also on this form. The EMB will assess what the each time we find a new and better way to maintain our patient is responsible for and what you must write off. documentation. Feel free to share any “pearls” that you have discovered. We will all benefit from them. ■ Insurance remittances are filed twice in the records. A copy of the EMB for a patient is placed in the chart along with a copy of the paper or electronic claim form. It is wise to date Dean Mason was first certified in 1998, following preparatory work at the form when it is submitted. We maintain a log of all paper Ball State University, Medical College of Wisconsin and X-tra Depth claims mailed in a notebook. The original EMB is filed by University. He was later certified as an orthotist in 2002 by BOC and company in the current year’s vendor and insurance files. was certified in 2007 by ABC. Mason started North Shore Pedorthics as This gives another reference in case of a lost document. a C.Ped. in 1998. His practice is centered on diabetic foot care, mostly in the at-home setting. He closely works with home health agencies, Documentation is time consuming, yet necessary part of providing in home care, with a reputation for providing common-sense what we do. Finding ways to streamline the process can be solutions to complex problems.
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40 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Association News
PFA Call for Abstracts DEMAND THE BEST PFA is looking for high-quality pedorthic professionals to present at PFA’s 52nd Annual Symposium & Exhibition, Your patients do! Nov. 10-13, at the Albuquerque Convention Center in Albuquerque, N.M. To be selected as a symposium presenter, Why shouldn’t you? please download and complete the call for abstracts form available at PFA’s Web site by Feb. 28. The symposium is about building knowledge and skills and developing expertise to meet the challenges of long-term ABC facility pedorthic footwear care. Sessions help attendees to: • Position themselves for success; accreditation is • Become informed and aware practitioners in the rapidly changing world of health care; BEST. • Develop new strategies to stay competitive in the market and prepared for future challenges; and We offer the: • Introduce innovative and practical solutions to daily pedorthic operations. :: Best value Presenters receive complimentary symposium registration, :: Highest standards as well as the publicity that comes with speaking at the premier event in pedorthics. :: Longest track record for excellence in the PFA Dues Slightly Increase in 2011 orthotic, prosthetic and pedorthic The PFA Board of Directors has approved a modest increase professions to all categories of membership dues effective with renewals beginning in January 2011. All membership categories will see their dues increased by $25 per year. The increase — the first in six years — reflects the increasing costs of operating We Can Help PFA and providing the products and services that are so critical to the pedorthic community. Contact us today at 703-836-7114 and join the best in the profession. “For the past six years, PFA has managed to keep its Download the accreditation dues steady,” said PFA President Kristi Hayes. “However, increases in postage and printing, labor, technology and guidelines and an application other components necessary to the operation of PFA have at www.abcop.org. continued to grow. As always, PFA works non-stop to look for new and exciting ways for members to maximize the value of their PFA membership, and we will be rolling out some of those new benefits in 2011.” PFA Members Approve Bylaws Changes PFA members attending the association’s annual membership meeting on Nov. 18 during the 2010 North American Pedorthic Congress in Orlando, Fla., overwhelmingly approved four significant bylaws changes, including; • Closed the loop on the disposition of the pedorthic educators committee by eliminating the pedorthic educator class of membership and the pedorthic educator committee’s voting representative to the board of directors; www.abcop.org DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND continued on page 51 THE BEST :: DEMAND THE BEST DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST
Pedorthic Footcare Association • www.pedorthics.org 41 2010 North American 2010 North American Pedorthic Congress Exhibitors Pedorthic Congress The Pedorthic Association of Canada and the Pedorthic Footcare Association would like to thank Sponsors the following companies for exhibiting at the 2010 North American Pedorthic Congress: The Pedorthic Association of Canada Acor Orthopaedic, Inc. Haflinger Pedorthic Research Foundation and the Pedorthic Footcare Association of Canada would like to thank the following Aetrex Worldwide, Inc. Hapad, Inc. PEL Supply Company companies for sponsoring the 2010 AGS Footwear Group Human Motion NA LLC North American Pedorthic Congress: Alps South Hush Puppies Pilgrim Shoes Pine Tree Orthopedic Lab, Inc. American Board for Certification Institute for Preventive in OP&P Foot Health Propet USA, Inc. American Shoe Corporation InStride-Xelero Shoes PW Minor Amfit Inc. International School of Renia GmS H The American Board for AON Affinity Insurance Services Pedorthics Riecken’s Orthotic Laboratory Certification (ABC) Apis Footwear Company Jerry Miller I.D. Shoes Right Way Custom Molded Arizona AFO, Inc. JMS Plastics Supply, Inc. Shoes, Inc. Ruby Leather & Orthopedic Co. Atlantic Footcare Justin Blair, Inc & Company Brooks Sports RX 24 Quadrastep System Australian Pedorthic Medical Kiwi Software Solutions Inc. Grade Footwear Association SAS Shoemakers KLM Laboratories Becker Orthopedic Sequoia/Comfort Rite Klogs USA National Pedorthics Berkemann Shoe Systems Plus, Inc. Knit-Rite, Inc. Bintz Company Silipos Kumfs Shoes of NZ Limited BioPed Franchising Inc. Skechers LL Custom Birkenstock USA, LP Smithers Bio-Medical Systems M.J. Markell Shoe Co., Inc. New Step Orthotic Lab, Inc. BOC International Sole Matplus Branier Custom Molded Shoes SoleScience/Evalix Mephisto Brooks Sports Soletech, Inc./Advance Footwear Miami Leather Co. Carl Semler (Semler Shoes) Solo Laboratories MMAR Medical Group, Inc. PartnerShip The Clinical Marketing Source Somnio MTB Footwear Cloud Nine Sheepskin Spenco Medical Corporation Cluffy Biomedical National Pedorthic Services, Inc. Spira Footwear, Inc. The Compliance Team, Inc. National Shoe Specialties Ltd. Sroufe Healthcare Products Propet USA, Inc. Coppi U.S.A. Inc. National Shoe Retailers STS Company Association Curtis Research Inc. Sunrise Shoes & Pedorthic Natural Step Services Corp Delcam New Balance Athletic Shoes, Inc. Superfeet Worldwide, Inc. Renia GmS H DIABCO-Healthcare Software Solutions LLC New Step Orthotic Lab Inc. Sure Foot Corporation Dia-Foot Nimco Orthopaedics bv Tauer & Johnson Comfort Footwear Doctor Specified Northwest Podiatric Laboratory TechMed 3D DOT Distribution Inc.. O&P Edge SAS Shoemakers Podiatech by Sidas O&R Shoe Corp, Inc. Tekscan, Inc. Thorlo, Inc. Dr. Comfort Oasis Footwear, LLC Topy Dr. Jill’s Foot Pads Orthaheel Tru-Mold Shoes Drew Shoe Corporation Orthofeet, Inc. UCO International Shoe Systems Plus, Inc. Dynamic Foot Systems LLC Ortoped Varifit Orthotics Ergoresearch Otabo Inc. Euro International Vers Tech Science Co Ltd PAL Health Technologies Finn Comfort (Kanner Vertical Foot Alignment Systems PartnerShip LLC Corporation) Pty Ltd Vibram Footech Ped Lite LLC Vibram Frankford Leather Co. Inc. Pedag USA Vittoria Phoenix, Inc. Gadean Footwear (Australia) Pedifix Footcare Inc. Waldlaufer USA Pty, Ltd. Pedors Shoes Waterhouse Leather Co, Inc. Vittoria Phoenix Vittoria Phoenix Guard Industries Inc. Pedorthic Foundation Wellness Life Systems
42 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Pedorthic Industry events
F AEbrU RY UP EU ON R Q EST February 14 – 19 Eneslow Pedorthic Institute 470 Park Avenue South @ 32nd Street, New York, N.Y. (deadline for exam application is Dec. 1, 2010) American Board for Certification in Orthotics, Prosthetics and Training and Tutoring Program, Individual and Small Groups Pedorthics (ABC) Contact Sarah Goldberg, 212-477-2300 ext. 211 or ABC Pedorthic Certification Exam [email protected] or visit www.eneslow.com/epi. Contact ABC at 703-836-7114 or e-mail [email protected] or visit COURSES www.abcop.org for more information. Robert M. Palmer M.D., Institute of Biomechanics MY A 1601 Main St., Elwood, Ind. Courses providing pedorthic education for the retail, clinical May 9 – 14 or biomechanical knowledge seeking pedorthist. Also offering (deadline for exam application is March 1) traveling courses to your area. Course dates for Levels 1-3 in a variety of locations in the United States, Hong Kong, Mainland American Board for Certification in Orthotics, Prosthetics and China and Korea are available. Pedorthics (ABC) Contact Pam Haig at 765-557-7216 or e-mail ABC Pedorthic Certification Exam [email protected]. Contact ABC at 703-836-7114 or e-mail [email protected] or visit For more information, visit www.pedorthicbiomechanics.org www.abcop.org for more information.
CFS Allied Health Education AUGUST Pedorthic Certification: Exam Review This program focuses on supplying the student with the skills August 8 – 13 and knowledge needed to pass the ABC Certified Pedorthic exam (deadline for exam application is June 1) by presenting exam-like questions, exploring possible answers, American Board for Certification in Orthotics, Prosthetics and and discussing rationales for correct and incorrect answers. Pedorthics (ABC) Call 918-266-3678 or visit www.LearnPedorthics.com for ABC Pedorthic Certification Exam additional information. Contact ABC at 703-836-7114, e-mail [email protected] or visit Scholl College at Rosalind Franklin University www.abcop.org for more Pedorthic Pre-certification Course Contact Ellie Wydeven, special programs office, 847-578-8410 N Ovember or e-mail [email protected]. For more information, visit November 10 – 13 www.rosalindfranklin.edu/scpm/ce. PFA 52nd Annual Symposium and Exhibition Riecken’s Orthotic Labs, 5115 Oak Grove Rd., Evansville, Ind. Albuquerque Convention Center SAFIO Class and Wax and Sand Casting Class, held on an Albuquerque, N.M. as-needed basis. Contact Charles at 800-331-8040, ext. 102. Call 202-367-1145 or e-mail [email protected]. For more information, visit www.pedorthics.org. November 14 – 19 (deadline for exam application is Sept. 1) MONTHLY American Board for Certification in Orthotics, Prosthetics and Riecken’s Orthotic Labs Pedorthics (ABC) 5115 Oak Grove Rd., Evansville, Ind. ABC Pedorthic Certification Exam SAFIO Class and Wax and Sand Casting Class, held on an as-needed basis. Contact ABC at 703-836-7114, e-mail [email protected] or visit Contact Charles at 800-331-8040, ext. 102. www.abcop.org for more JANUA RY 2011 N Ovember 2012 January 24 – February 7 November 1 – 4 PFA 53rd Annual Symposium and Exhibition Eneslow Pedorthic Institute, New York, N.Y. Pedorthic Pre-Certification Class Statehouse Convention Center Contact: Sarah Goldberg, 212-477-2300, [email protected] or visit Little Rock, Ark. www.eneslow.com/epi. Contact 202-367-1145, e-mail [email protected] or visit Contact Charles at 800-331-8040, ext. 102. www.pedorthics.org for more information.
Pedorthic Footcare Association • www.pedorthics.org 43 Industry News
Therapeutic Shoes: New Policy Revision/Documentation Requirements A revision of the Therapeutic Shoes Policy Article (PA) has The supplier must obtain a signed statement from the been released. In addition, the following revision to the physician who is managing the patient’s systemic diabetes Documentation Requirements section of the LCD is being condition (i.e., the certifying physician) specifying that the made. It will be incorporated in a subsequent revision of the patient has diabetes mellitus, has one of conditions 2a-2f Therapeutic Shoes LCD. listed in the related policy article, is being treated under a comprehensive plan of care for his/her diabetes, and needs An order for each item billed must be signed and dated by the diabetic shoes. The certifying physician must be an M.D. or prescribing physician, kept on file by the supplier and made D.O and may not be a podiatrist, physician assistant, nurse available upon request. Items billed before a signed and dated practitioner or clinical nurse specialist. The “Statement of order has been received by the supplier must be submitted Certifying Physician for Therapeutic Shoes” form (see LCD with an EY modifier added to each affected HCPCS code. Attachments section below) is recommended. Whatever form If the prescribing physician is the supplier, a separate order is is used must contain all of the elements contained on the not required, but the item provided must be clearly noted in recommended form attached to this LCD. This statement the patient’s record. must be completed, signed and dated by the certifying physician and must be received by the supplier prior to claim A new order is not required for the replacement of an insert submission. A new certification statement is required for a or modification within one year of the order on file. However, shoe, insert or modification provided more than one year the supplier’s records should document the reason for the after the most recent certification statement on file. replacement. A new order is required for the replacement of any shoe. A new order is also required for the replacement of There must be information in the medical records of the an insert or modification more than one year from the most certifying physician that: recent order on file. For claims with dates of service on or 1. Documents management of the patient’s diabetes; and after Jan. 1, 2011, the detailed written order must be signed on or after the date of the visit with the prescribing physician 2. Documents detailed information about the condition (see related Policy Article for information about the visit with (2a-2f listed in the related policy article) that qualifies the the prescribing physician). patient for coverage.
Activity Responsible Person Requirements1 1 Visit to document diabetes Certifying MD/DO Within six months prior to delivery management2 2 Visit to document Certifying MD/DO, other Within six months prior to delivery qualifying foot condition2 MD/DO, DPM, PA, NP, CNS 3 Completing Certification Certifying MD/DO After visit(s) to document diabetes management and qualifying Statement foot condition2 After Certifying Physician reviews and signs report of visit documenting qualifying foot condition by other MD/DO, DPM, PA, NP, CNS – if applicable3 Prior to initial provision of shoes and inserts For subsequent provision of shoes and inserts, required if delivery is more than one year after most recent Certification Statement 4 Providing dispensing order Prescribing physician After visit with Prescribing physician 4 to supplier Before delivery 5 Signing detailed written Prescribing physician After visit with Prescribing physician order 6 Selection visit Supplier 7 Delivery visit Supplier After selection visit After receiving dispensing order or detailed written order 8 Submitting claims Supplier After delivery After receiving detailed written order After receiving Certification Statement
1 If the table states that one event needs to occur “before” or “after” another event, both could occur on the same date if that sequence was followed. 2 Effective for dates of service on/after 1/1/2011. 3 Applicable if qualifying foot condition is not documented on visit with Certifying Physician. 4 Separate dispensing order not needed if detailed written order received by supplier prior to delivery.
44 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 The certification statement by itself does not meet this 2008. This policy revision incorporates information that requirement for documentation in the medical records. The was published in an article in May 2010. in-person evaluation of the patient by the supplier at the time of selecting the items that will be provided (refer to related 2. Certification statement. The Medicare statute – Social policy article, non-medical necessity coverage and payment Security Act, Title XVIII, Section 1861(s)(12) – states that rules, criterion 4) must include at least the following: the physician who is managing the individual’s diabetic condition must (1) document that the patient has one of 1. An examination of the patient’s feet with a description of several specified conditions that predispose the patient the abnormalities that will need to be accommodated by to diabetic ulcers of the feet and (2) certify that the the shoes, inserts and/or modifications; individual needs therapeutic shoes and inserts under a comprehensive plan of care related to their diabetes. The 2. For all shoes, taking measurements of the patient’s feet; and DME MACs have received a number of questions relating 3. For custom molded shoes (A5501) and inserts (A5513), to the timing and sequencing of visits and other activities taking impressions, making casts or obtaining CAD-CAM related to this requirement. The policy revision clarifies images of the patient’s fee that will be used in creating these requirements. positive models of the feet. The statute, national policy and LCD/PA identify three entities The in-person evaluation of the patient by the supplier at the involved in the provision of therapeutic shoes: Certifying time of delivery (refer to related policy article, non-medical Physician, Prescribing Physician, and Supplier. Definitions necessity coverage and payment rules, criterion) must be of these entities are found in the Therapeutic Shoes Policy conducted with the patient wearing the shoes and inserts and Article. The following table summarizes the sequence and must document that the shoes/inserts/modifications fit properly. timing of the various steps required for the coverage of therapeutic shoes and inserts. The ICD-9 code that justifies the need for these items must be included on the claim. These revisions address two main areas: Editor’s note: The information contained in this article is only a summary of requirements. For complete information, you 1. In-person fitting and delivery. This requirement is included must review the entire LCD and Policy Article available on PFA’s 64093Riecken_50-50PFA_ad_2.qxpin the DMEPOS Quality Standards 8/17/2010 published in11:20 October AM Pagewebsite 1 at www.pedorthics.org.
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Pedorthic Footcare Association • www.pedorthics.org 45 Industry News
M edicare Imposes Stronger Protections and walkers to complex power wheelchairs, oxygen supplies and equipment and hospital beds now must meet these new on Medical Equipment Suppliers standards. This final rule will: New Rule Strengthens Supplier Enrollment • Require DMEPOS suppliers to obtain oxygen from a state- Standards to Help Prevent Fraud licensed oxygen supplier (applies only in states that require oxygen licensure); The Centers for Medicare & Medicaid Services (CMS) • Require DMEPOS suppliers to remain open to the public recently issued a final rule representing another step for at least 30 hours a week, with exceptions for physicians to increase protections for Medicare and beneficiaries or licensed non-physician practitioners furnishing services from potentially fraudulent suppliers of durable medical to their own patient(s) as part of their professional service equipment, prosthetics, orthotics and supplies (DMEPOS). and DMEPOS suppliers working with custom made The new regulation enhances Medicare enrollment standards orthotics and prosthetics; for DMEPOS suppliers by adding several new standards • Ensure that DMEPOS suppliers continue to maintain and strengthening existing standards that suppliers must ordering and referring documentation from physicians or meet before being able to furnish equipment and supplies non-physician practitioners; and to Medicare beneficiaries. These new, stronger standards will • Prohibit DMEPOS suppliers from sharing a practice help to reduce fraud in Medicare and provide beneficiaries location with certain other Medicare providers and with additional assurance that they are being served by suppliers subject to certain exceptions. legitimate suppliers who meet Medicare’s standards. The final rule also clarifies and expands the existing The additions and revisions to the DMEPOS supplier enrollment requirements that DMEPOS suppliers must meet enrollment standards help ensure that only qualified and to establish and maintain billing privileges in the Medicare legitimate DMEPOS suppliers participate in Medicare. All program. Specifically, this final rule will revise current suppliers for these items, including those DMEPOS items supplier standards to ensure that the DMEPOS supplier prescribed by the beneficiary’s physician, from simple canes maintains a physical facility on an appropriate site that must: • measure at least 200 square feet, except for state-licensed orthotic and prosthetic personnel providing custom fabricated orthotics or prosthetics in private practice; • be in a location that is accessible to the public, Medicare beneficiaries, CMS, the National Supplier Clearinghouse FREE (NSC) and its agents (not in a gated community or other Pedorthic e-newsletter area where access is restricted); • be accessible and staffed during posted hours of operation; maintain a permanent visible sign in plain view and post hours of operation; • be in a location that contains space for storing business records, including the supplier’s delivery, maintenance, and beneficiary communication records; The Professional Publication of FOOT.com • prohibit the use of cell phones, beeper numbers and pagers as a primary business telephone number. In addition, Stay informed with Pedorthic Newswire, the industry’s primary weekly answering machines and answering services may not be e-newsletter. Receive vast information relevant to footwear and footcare used exclusively as a supplier’s primary telephone number retailers, foot health professionals and more. Communicate and connect during posted business hours; and with fellow industry professionals regarding the latest news and trends, • expand the prohibition on a DMEPOS supplier’s telephone pedorthic reimbursement, diabetes, products, upcoming courses and solicitation of a Medicare beneficiary to also include information on becoming a certified pedorthist. And all of this is free! in-person contacts, e-mails, instant messaging and Internet Simply email us at [email protected] with “subscribe” coercive advertising. in the subject line. Pedorthic Newswire is a professional service of Foot.com, the #1 foot health site on the internet. ABC Launches Redesigned Consumer Web Site 414 Alfred Avenue, Teaneck, NJ 07666 The American Board for Certification in Orthotics, Prosthetics 800-526-2739 | www.aetrex.com and Pedorthics, Inc. (ABC) is pleased to announce the launch of its newly redesigned and updated consumer Web
46 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 TM site, OandPCare.org. The redesign was initiated to provide consumers with valuable and comprehensive information about the orthotic, prosthetic and pedorthic professions. The littleSTE Web site’s new contemporary look and feel makes navigating PS the site easier than ever before. foot orthotics for kids The Web site features an intuitive and more user-friendly TM interface along with a detailed directory to locate care providers and facilities by state, city, zip code or expertise. Each provider category includes frequently asked questions and glossary sections giving consumers valuable information on what they can expect during their relationship with their orthotist, prosthetist, pedorthist or other care team member. In addition to more patient specific information, the Web site also provides a section designed for caregivers or individuals supporting someone who is living with a prosthesis or Sizes fit orthosis. Whether they are caring for a loved one, a rehab most kids ages patient or providing long-term care, the information provided on the Web site will help them to understand the terminology 12 and younger and find resources for additional information and support. ABC feels that it is important to aid consumers in finding Designed to Improve: the answers and resources they need for all of their orthotic, prosthetic and pedorthic care needs. Given that in most states there are no requirements for education, certification Coordination Balance or licensure for orthotists, prosthetists or pedorthists, it is important for consumers to take a proactive approach Pain Posture in determining who they choose to work with — being informed will only help them gain a positive outcome. Foot Alignment Strength For more information, visit www.oandpcare.org
ABC Announces Additional The most corrective pediatric Prefab foot Exam Dates for 2011 orthotic on the market! The American Board for Certification in Orthotics, Prosthetics UCBL-Type design with 30mm heel cup depth. and Pedorthics, Inc. (ABC) has added a new set of dates for administering its certification exams for 2011. The new dates Medial and Lateral Flanges. will give ABC a total of four exam administrations each year, Medial Rearfoot posting and skive. allowing candidates additional opportunities to take the exams. The dates for the 2011 ABC certification examinations littleSTEPS™are a for orthotists, prosthetists, pedorthists, orthotic fitters, product of mastectomy fitters and therapeutic shoe fitters are: Nolaro24,LLC maker of the 100 • Feb. 14-19; QUADRASTEP TM SYSTEM • May 9-14; 95 • Aug. 8-13; and • Nov. 14-19. littleSTEPS. . . 75 Big Results! The ABC Board made the decision to add the additional exam administration to increase candidate access to the exam. The change also reflects the changing academic environment 25 where orthotic, prosthetic and pedorthic education occurs year round as opposed to the traditional academic year. 877.792.4669 5 For more information on ABC’s certification exams and www.footorthoticsforkids.com 0 applications deadlines, visit www.abcop.org. [email protected] continued on page 50
CuPedhalfvertpressPedorthic Footcare Association • www.pedorthics.org 47 Wednesday, October 13, 2010 10:13:02 AM Government Affairs
Important Update on PECOS & 2. Use Internet-based PECOS to look for your PECOS enrollment record, available at www.cms.gov. If no Ordering/Referring record is displayed, you do not have an enrollment record in PECOS. At this time the Centers for Medicare and Medicaid Services (CMS) has not turned on the automated edits that would 3. Contact your designated Medicare enrollment contractor deny claims for services that were ordered or referred by a and ask if you have an enrollment record in PECOS. Visit physician or other eligible professional simply for lack of an www.cms.gov for the “Medicare Fee-For-Service Contact approved file in PECOS. CMS is working to resolve backlog Information” list (in the “Downloads” section). and other systems issues and will provide ample advance notice to the provider and beneficiary communities before any If you are not yet in PECOS, the best way to submit your such automatic denials begin. While there are some rumors application is through Internet-based PECOS. that the edits will be turned on in January, CMS has reiterated that it has not announced any date (Jan. 3 or otherwise) as to when ordering/referring edits will be turned on. Reminder: Physician Documentation
Physicians or other eligible professionals not currently Responsibilities enrolled in PECOS should take the initiative to enroll sooner Suppliers are also encouraged to include language in rather than later. There are three ways to verify that you have their cover letters to physicians reminding them of their an enrollment record in PECOS: responsibilities. 1. Check the Ordering Referring Report on the CMS website, Reference: Internet Only Manual, Publication 100-8, available at www.cms.gov. If you are listed on that report, Medicare Program Integrity Manual, Chapter 5, Section you have a current enrollment record in PECOS. 5.3.2. ■
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48 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Coding, Billing and reimbursement
HHS OIG Announces Analysis of Errors Identified in the Fiscal Year 2009 Comprehensive Error Rate Testing Program The U.S. Department of Health and Human Services’ (HHS) Office of the Inspector General’s (OIG) review found that six types of health care providers accounted for $4.4 million, or 94 percent, of the $4.7 million in improper payments identified by CMS’s Comprehensive Error Rate Testing (CERT) contractor for fiscal year (FY) 2009. The provider types comprised inpatient hospitals, durable medical equipment suppliers, hospital outpatient departments, physicians, skilled nursing facilities and home health agencies. As part of the Medicare error rate process, the CERT contractor conducted medical record reviews of a random sample of paid claims from all types of providers. Based on the results of those reviews, the Centers for Medicare and Medicaid Services (CMS) reported to Congress that the national Medicare error rate for FY 2009 was 7.8 percent or $24.1 billion. The Improper Payments Information Act of 2002 requires that CMS estimate improper Medicare fee-for-service payments each year. HHS OIG’s analysis of the erroneous claims identified by the CERT contractor found that three types of errors accounted for about 98 percent of the $4.4 million in improper payments attributable to the six types of providers: • Insufficient documentation (e.g., missing clinical notes or test results and missing, incomplete or illegible physician orders), which resulted in improper payments totaling $2.6 million; • Miscoded claims, which resulted in improper payments totaling $0.9 million; and • Medically unnecessary services and supplies, which resulted in improper payments totaling $800,000. HHS recommended that, as part of its analysis of the FY 2009 CERT improper payments, CMS use the results of the analysis in identifying the types of payment errors indicative of programmatic weaknesses and any additional corrective actions needed to strengthen the CERT program. CMS concurred with the OIG’s recommendation. Visit the breaking news section of PFA’s Web site to view the complete report from the HHS OIG.
HCPCS Codes A5500, A5512 and A5513 – Service-Specific Pre-pay Review CIGNA Government Services, the Jurisdiction C DME MAC, will be implementing service-specific Medical Review edits
continued on page 50
Pedorthic Footcare Association • www.pedorthics.org 49 Coding, Billing and reimbursement continued from page 49 for Healthcare Common Procedure Coding System (HCPCS) 4. Supplier in-person evaluation conducted prior to selection codes A5500 for diabetics only, fitting [including follow- of items that documents an examination of the beneficiary’s up], custom preparation and supply of off-the-shelf depth- feet with a description of the abnormalities that will need inlay shoe manufactured to accommodate multi-density to be accommodated by the shoes/inserts/modification; insert[s]); A5512 for diabetics only, multiple density insert, direct formed, molded to foot and A5513 for diabetics 5. In-person visit, at the time of delivery, which assesses only, multiple density insert, custom molded from model of the fit of the shoes and inserts with the beneficiary patient’s foot. These edits are the result of data demonstrating wearing them; a high claims payment error rate for this product category. 6. Delivery documentation with the beneficiary’s name and address and the description of the items provided; and Claims subjected to these edits will be developed for additional documentation. Suppliers receiving a development 7. Any other pertinent records. letter should follow the instructions contained in the letter for the specific documentation requested. Suppliers will be asked Relevant medical records consist of physician notes, non- to submit documentation including, but not limited to: physician clinical notes and non-physician clinical evaluations that verify that the patient’s condition meets coverage criteria 1. Prescribing physician’s detailed written order; for therapeutic shoes for persons with diabetes. The source 2. Completed signed and dated statement from the certifying of these records may be a physician’s office, hospital, nursing physician (physician managing the beneficiary’s systemic home, home health agency, wound clinic, etc. Evaluations diabetes condition) specifying that the beneficiary has used to determine coverage must have been performed and diabetes and: recorded prior to delivery and performed by a clinician who does not have a financial relationship with the supplier. a) Previous amputation of the other foot, or part of either foot The information must be received within 30 days of the date b) History of previous foot ulceration of either foot of the letter or the claim will be denied. Additional information on this and other documentation requirements for codes c) History of pre-ulcerative calluses of either foot A5500, A5512 and A5513 may be found on the CGS Medical d) Peripheral neuropathy with evidence of callus formation Review Web site at www.cignagovernmentservices.com/jc/ of either foot coverage/MR/index.html e) Foot deformity of either foot f) Poor circulation in either foot. Reminder: Name on Claim Must And is being treated under a comprehensive plan of care for his/her diabetes and needs diabetic shoes. Match Medicare ID Card Suppliers are reminded that the beneficiary name reported 3. Relevant medical records where the certifying physician on the claim must be the name shown exactly on the either personally documented that the beneficiary met beneficiary’s Medicare ID card. one or more of criteria 2a – 2f or obtained documentation from another clinician documenting the beneficiary met If the beneficiary name submitted does not match the name one or more of criteria 2a – 2f and the certifying physician in the Social Security Administration files for that beneficiary indicated agreement with the information by initialing and claim number, Medicare will delete and return the claim to dating the record; the supplier. The claim must be corrected and resubmitted. ■
I ndustry News continued from page 47 Four Win $1,000 at Orlando Congress The raffle raised more than $8,000 for the two research foundations. The funds will support a variety of foundation Four lucky attendees at the North American Pedorthic activities that include research, education and a new U.S. Congress in Orlando, Fla. won $1,000 each in a raffle program called “Feet for Life,” which will enable credentialed sponsored by the Pedorthic Foundation and the Pedorthic pedorthists to help their lower-income patients with diabetes Research Foundation of Canada. The winners at the to access a free pair of shoes. international event came from three countries — two from the United States, one from Canada and one from Australia. The cash prizes were donated by long-term PFA exhibitors Arizona AFO Inc., P.W. Minor and KLOGS USA joined Raffle winners included: this year by Paris Orthoics of Vancouver, British Columbia, • Michael Veder, Eaton, Ohio; Canada. • Catriona Churman, Winnepeg, Manitoba, Canada; • Neil Smith, Sydney, Australia; and For more information on “Feet for Life” or Pedorthic • Maureen Wiese, Happy Valley, Oregon. Foundation activities, visit www.pedorthicfoundation.org. ■
50 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Association News continued from page 41 • Administrative language revisions in numerous sections of Pricing changes for FedEx Ground and FedEx SmartPost for the bylaws designed to streamline and further modernize calendar year 2011 will be announced later this year. the governing document and maintain consistency with changing non-profit regulations at the federal and local Also effective Jan. 3, the cost to ship with UPS ground and (District of Columbia) levels; express services will increase by a net average 4.9 percent for U.S. domestic and U.S. export services. The rate increase • Housekeeping language changes in sections of the bylaws for UPS ground shipments is achieved through a 5.9 percent that were approved by the membership in 2008; and increase in the base rate, less a 1 percent reduction to the • Revised the section concerning medical advisors to provide index-based ground fuel surcharge. The rate increased for the board with more flexibility to determine the each year UPS air express and international shipments is based on a 6.9 the number of medical advisors, rather than the current percent increase in the base rate, less a 2 percent reduction to requirement of a fixed number of three advisors. the index-based air and international fuel surcharge.
The changes to the bylaws are effective immediately and are Dimensional Weight Calculation Change available at www.pedorthics.org. In addition, both FedEx and UPS will implement a change to the dimensional weight volumetric divisor, from 194 to 166 Fed Ex and UPS to Raise Small for U.S. domestic air and ground services. The DIM factor has also changed from 166 to 139 for international shipments. Package Rates for 2011 The lower DIM factors may have a substantial impact in the form of higher shipping rates for companies whose packages The PFA Discount Shipping Program, managed by PartnerShip, are subject to dimensional weighting, such as retailers and recently announced that FedEx Corp. and UPS will increase companies that ship lower density packages. envelope and small package shipping rates for 2011. Details of dimensional weight charges and additional changes Effective Jan. 3, the cost to ship an overnight envelope with that will be made to other FedEx Express surcharges can be FedEx Express will increase by a net average of 3.9 percent. found at www.fedex.com/us/2011rates. Updated UPS rate The full average rate increase of 5.9 percent will be partially and service information can be found on www.ups.com/rates. offset by adjusting the fuel price threshold at which the fuel On Jan. 3, when the new rates take effect, customers can surcharge begins, reducing the fuel surcharge by 2 percent. download the 2011 Rate and Service Guide. ■
Advertiser Index Advertiser Page Web site Acor Orthopaedic, Inc. 11 www.acor.com Aetrex Worldwide, Inc. 7, 46, BC www.aetrex.com AGS Footwear Group 21 www.agsfootweargroup.com American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. 20, 41 www.abcop.org Apis Footwear Co. 36 www.apisfootwear.com Brooks Sports 15 www.brooksrunning.com Dr. Comfort 4 www.drcomfortdpm.com JMS Plastics Supply, Inc. 23 www.jmsplastics.com Kanner Corporation 3 www.finncomfort.com KLM Orthotics Lab 19 www.klmlabs.com MMAR Medical Group, Inc. IFC www.mmarmedical.com Natural Step 27 www.naturalstepshoes.com New Balance IBC www.newbalance.com New Step Orthotic Lab, Inc. 25 www.newsteporthotics.com Nolaro 24, LLC 47, 49 www.whatsmyfoottype.com Orthofeet, Inc. 17 www.orthofeet.com Orthoheel/Vasyli Medical 9 ww.orthaheelusa.com & www.vasylimadical.com PEL Supply Company 13 www.pelsupply.com Propet USA, Inc. 33 www.propetusa.com Riecken’s Orthotic Laboratories 45 www.footcomfortworld.net Rowan Billing Services 31 www.rowanbillingservices.com Sroufe Healthcare Products 37 www.shercoinc.com Verne Bintz Company 40, 48 www.bintzco.com
Pedorthic Footcare Association • www.pedorthics.org 51 Pedorthic marketplace
HELP WANTED trained technicians, technical support and clerical FOR SALE personnel. This department is growing and the position is ideal for an experienced Pedorthist that RETAIL SALES REPS has the ability to manage and meet production BUSINESS SOFTWARE Xelero “makes walking easier.” Casual, athletic, deadlines. Health benefits and 401K matching SPECIFICALLY DESIGNED FOR therapeutic. Looking to add retail oriented sales program round out a generous salary package. ORTHOPEDIC SHOE STORES representatives in several key territories. High Respond to [email protected] commission! Please forward resumes and agency/ Orthopedic Shoe Store Automation (OSSA) will help rep profiles to [email protected]. you manage and grow your business. OSSA software FULL- OR PART-TIME MEDICAL is network ready and runs on a standard PC with SALES REPRESENTATIVE , XP or Vista. Inventory management is FULL-TIME & PART-TIME Microsoft 2000 Location - nationwide. Medical Dynamics, LLC a snap because OSSA uses the standard UPC barcode POSITIONS AVAILABLE is looking for qualified sales representatives. on the products to automate the inventory process. Medical Dynamics is a national Durable Medical Enjoy patient care? Like to work independently? Records can be transferred to OSSA from QuickBooks Ability to set your own schedule? Equipment provider, specializing in orthotics and diabetic footwear. We are currently looking and other record keeping systems. Features include: Wellness Life Systems is one of the leading for sales professionals to develop new accounts • Point of Sale diabetic shoe providers in the nation and growing nationwide. If you have sales experience or you are fast. We are ACHC accredited, HIPAA compliant a physical or occupational therapist looking for a • Inventory management and seeking highly motivated Certified Pedorthists new challenge, we want to talk to you. • Patient records (unlimited) with excellent communication skills. This unique opportunity will allow the right individuals to: Qualified Candidates Must Have: • Order processing • Get back to patient care! Perform in home • Ability to think independently and creatively • Scheduling diabetic foot evaluations, shoe fittings and • Exceptional interpersonal skills • Powerful mailing capabilities deliveries in your local area. • Ability to develop strong customer loyalties • Physician referrals linked to patient sale • Manage your own territory and set your • Strong organizational skills and you must be a • Track advertising results own schedule. driven, self starter • Diabetic reminder notices Areas of need include: Arizona - Phoenix, Flagstaff; These are a plus: California; Colorado - Fort Collins, Greeley, Boulder; • Employee sales performance • COF Kansas; Panhandle of Florida; Iowa - Des Moines, • Commission processing Council Bluffs, Sioux City; Indiana - Fort Wayne, • Physical or Occupational Therapist or Assistant • Employee time clock Evansville, Bloomington, South Bend; Nebraska - • BOC Certified Omaha, NV - Las Vegas, Reno, Carson City; Ohio - • Patient photo management • DME sales experience Toledo; Oregon - Portland, Eugene, Salem, Medford, • Full security Pennsylvania, Virginia, Washington D.C., West • C. Ped. • Patient charting Virginia and much more. Give us a call to find out • Outside Sales Experience if we have an opening in your area!! E-mail your • Document management (paperless office) resume today to [email protected] or This is an uncapped commission structure that call Frank O’Rourke 816-268-6857. provides continual cash flow. With this opportunity, • Insurance code processing you can realistically generate a six (6) figure • Business reports income, or it can be utilized as a supplemental C. PED./L. PED. NEEDED income. If this opportunity matches your desires • Track sales from doctor referrals Immediate opening for an ABC Certified/Licensed and experience, please contact us immediately. • GMROI We have an immediate need to fill this Pedorthist for Middle Tennessee area. Established Call or e-mail Engwer & Associates at 412-751-2433 practice is seeking highly motivated Practitioner position. E-mail your resume and references to [email protected] to schedule a comprehensive online with at least three years clinical experience, [email protected] only those management skills and organizational skills. candidates who meet our needs will be contacted. demonstration of OSSA. (121708C) Competitive salary and benefits available. E-mail [email protected]. To place a classified ad contact [email protected], CUSTOM FOOTWEAR send a fax to (202) 367-2145, or mail to Current Pedorthics, PRODUCTION MANAGER 2025 M St., NW, Suite 800, Washington, DC 20036. Acor has an immediate opening for the manager of its custom Pedorthic/Orthotic department in Classified Advertising Rates Cleveland, Ohio. This person is responsible for the professional timely production of custom foot Words PFA Member PFA Non-Member orthosis (cad-cam and traditional construction), 50 or fewer words $25 $45 crow walkers, gauntlets and custom shoes. Management, training and pacing the production 51-75 words $45 $65 staff is a daily responsibility. Answering customer 76-150 words $65 $125 questions about proper construction of orthopedic devices as it relates to patient need is also a The above rates are calculated by counting complete words. daily occurrence. The current staff is comprised of (A telephone number is counted as a complete word.)
52 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Product Reference Guide
This reference guide is intended solely to make it easier for individuals, facilities and companies to locate pedorthic products. Companies listed in the guide are PFA vendor/manufacturer members. Companies may produce additional products beyond those listed, and most companies are pleased to provide additional information on request. As a courtesy to our readers, CP has noted the year the company joined PFA in parentheses after the company’s name. Inclusion in this list does not suggest or imply PFA endorsement of companies or products. To arrange changes in your company’s listing, e-mail [email protected].
Acor (1979) Brooks Sports, Inc. (2001) Apis Footwear Company (2000) Walking/athletic shoes in women’s and men’s styles. Delivery Custom and comfort footwear, inserts and materials. Women’s footwear, 103 sizes; men’s footwear, 98 sizes. Open includes special orders. Originator of Tri-Lam and P-Cell. stock for immediate delivery. Bothell, WA...... 800-2-BROOKS Cleveland, OH...... 800-237-2267 S. El Monte, CA...... 888-937-2747 Fax...... 425-483-8181 Fax...... 216-662-4547 Fax...... 626-448-8783 E-mail ...... [email protected] E-mail ...... [email protected] E-mail ...... [email protected] Website ...... www.brooksrunning.com Website ...... www.acor.com Website ...... www.bignwideshoes.com Cluffy Biomedical (2008) Arizona AFO, Inc. (2003) Great Falls, MT ...... 406-590-3668 Arizona AFO manufacturers a line of medical ankle braces Fax...... 406-761-7219 for the treatment of foot disorders. The Arizona AFO line E-mail ...... [email protected] is used by physicians and practitioners as a way to increase Aetrex Worldwide, Inc. (1973) mobility, avoid pain, avoid surgery and provide a better quality of life. C.N. Waterhouse Leather Co., Inc. (1998) Aetrex Worldwide has been a supplier of footcare products Manufacturer and distributor of fine leathers, woolskins, ® for 60 years. Aetrex’s brands include Aetrex and Apex Mesa, AZ ...... 480-222-1580 suede pig-skins, sheet goods and adhesives for use in the ® ® Footwear, Lynco Orthotics, iStep and raw materials. Fax:...... 480-461-5187 pedorthic footwear and orthopedic industries. Teaneck, NJ...... 800-526-2739 E-mail:...... [email protected] Website:...... www.arizonaafo.com Bedford, MA...... 800-322-1177 Fax...... 201-833-1485 Fax...... 781-271-0499 E-mail ...... [email protected] E-mail ...... [email protected] Website ...... www.aetrex.com Curtis Software, Inc. (2009) Affinity Insurance Services, Inc. (1998) Curtis Software is a unique medical billing software Affinity Insurance Services administers the PFA product company. What makes us unique is that we use our own and malpractice liability insurance program. Designed for software on a daily basis in our national billing company pedorthists, insurance protection can be customized for called ClaimCare. Our company started as a nationwide each‑PFA member. billing service in 1986. Our company will do any type Chicago, IL...... 800-544-2672 Bintz Company, Inc. (1991) of medical billing, including DME, specialized pharmacy, Fax...... 312-922-9321 Distributor of pre-molded orthotics, comfort foot products, physical therapy and physician claims. sheet goods and fitting aids. Products from Birkenstock, Pedag, Spenco, Pedifix, Knit-Rite, Powerstep, Hapad, Sroufe, Akron, OH...... 800-648-2377 Khepra and more. Fax...... 330-376-9812 E-mail ...... [email protected] Wheaton, IL...... 800-235-8458 Website ...... www.curtis.lek.net Fax...... 630-653-5077 AGS Footwear Group (1995) E-mail ...... [email protected] Shoe store supplies, fabricating materials, prefabricated Website ...... www.bintzco.com DB Shoes Ltd. (2003) orthotics, heel cups and forefoot supports. Manufacturers of direct injection molded footwear. Ashland, VA...... 800-446-3820 Biomechanical Services Inc. (2004) Rushden, Norhamptonshire, England . +00 44 1933 359217 Fax...... 800-822-0180 Custom foot orthotics as well as lower extremity evaluation Fax...... +00 44 1933 410218 E-mail ...... [email protected] systems, custom sandals, prefabs, balance therapy tools and E-mail ...... [email protected] Website ...... www.agsfootweargroup.com educational courses. Technical support services. Website ...... www.dbshoes.co.uk Brea, CA...... 800-942-2272 AliMed, Inc. (2004) Fax...... 714-990-4060 Doctor Specified (2008) Orthopedic products including orthoses and orthotic E-mail ...... [email protected] The Doctor Specified line has been specially developed for materials, orthopedic supports, walkers and shoes, Website ...... www.biomechanical.com the discerning consumer or those among us with foot or therapeutic modalities, diabetic footwear and more. general health issues. The line includes Diabetic and Medical Dedham, MA...... 800-225-2610 Grade categories, which feature socks that are specific in Birkenstock USA, LP (1990) need and technically advanced. Fax...... 800-437-2966 U.S. distributor of Birkenstock sandals, shoes, clogs and E-mail ...... [email protected] arch supports, and also representing Footprints® shoes and By incorporating features such as hand-linked seamless Website ...... www.alimed.com Birko Orthopädie arch supports. toes, extra-deep heel wells, and our proprietary Med Dry® moisture management system, we have produced a product Novato, CA ...... 800-949-7301 line unique to the U.S. market. American Sporting Goods Corp. (2009) Fax...... 415-884-3250 Aliso Viejo, CA...... 949-267-2800 E-mail ...... [email protected] Hickory, NC...... 828-485-3316 Fax...... 949-225-6386 Website ...... www.birkenstockusa.com Fax...... 828-485-0049 E-mail ...... rhovis@asg-avia.com E-mail ...... [email protected] Website ...... www.doctorspecified.com Branier Orthopedic Custom Molded Shoes (2004) Amfit Inc. (1996) Catalogue contains over 40 styles. Can duplicate any shoe Footfax-SL 3D Contact Digitizer, Footprinter Foam Casting on the market. 12-day turnaround, great fit! Dr. Comfort (2004) System, precision CAD/CAM Carving Mill, accommodative Dr. Comfort manufactures, warehouses and distributes the Sunrise, FL...... 877-524-0639 and functional custom foot orthoses and orthotic sandals. finest quality extra-depth shoes for diabetics or patients who Fax...... 954-727-2608 need quality comfort shoes. Vancouver, WA...... 800-356-3668 E-mail ...... [email protected] Fax...... 360-566-1380 Website ...... www.branier.com Mequon, WI...... 262-242-5300 E-mail ...... [email protected] Fax...... 262-242-9300 Website ...... www.amfit.com E-mail ...... [email protected] Website ...... www.drcomfortdpm.com
Pedorthic Footcare Association • www.pedorthics.org 53 Product Reference Guide
Dr. Kong Footcare Limited (2005) Gadean Footwear (2010) JMS Plastics Supply (1992) Manufacturer of children’s, men’s and women’s healthy shoes Gadean Footwear is the largest orthopaedic shoemaker JMS Plastics distributes all your needs to make a quality insoles, footcare accessories and computerized assessment in Australia. Gadean Footwear provides retailers with Foot Orthotic. We stockTL-2100/ TL-silver and now XTX software. 33 chain shoe shops in Hong Kong. Provides washable slippers, motion shoes, fashion shoes, depth shoes, our newest composite material. Along with a complete line check and fit services and healthy products for everybody. removable insole sandals and many more products. of EVA in many colors/ thicknesses and durometers. JMS Kwai Chung, N.T., Hong Kong ...... 852-2744-2638 Mt. Hawthorn, Western Australia, Australia. . 08-9208 1000 now carries a complete line of insoles, from The Healix care Fax...... 852-2744-8845 Fax ...... 08-9443 9915 footbeds with Bamboo and Silver top covers to Superstep E-mail ...... [email protected] E-mail ...... [email protected] in 3 rigidities and the complete line of Sof Sole insoles. JMS Website ...... www.dr-kong.footcare.com.hk Website ...... www.gadeanfootwear.com.au is the first company to have a Bamboo top cover laminated onto Neoprene. Bamboolon comes in sheets. We also carry a full line of Poron in sheets/wheels and rolls. Call 1-800-342- Drew Shoe Corporation (1968) Guard Industries, Inc. (1996) 2602 for free samples and a current catalog. Men’s and women’s depth and comfort footwear in over Components for shoe care, foot comfort, orthotics and Neptune, NJ...... 800-342-2602 150 sizes. prosthetics. Complete listing of available products will be Fax...... 732-918-1131 Lancaster, OH ...... 800-837-3739 sent upon request. Website ...... www.jmsplastics.com Fax...... 740-654-4979 St. Louis, MO...... 800-535-3508 E-mail ...... [email protected] Fax...... 314-534-0035 Website ...... www.drewshoe.com E-mail ...... [email protected] Justin Blair & Company (2001) Website ...... www.guardmfg.com Manufacturer of Ralyn Shoe Care and Backroom Supplies and NightCare Foot Care. Distributor for Aetrex, Acor, Darco, eSoles (2009) Herbal Concepts, Pedifix, Swede-O, Silipos and Therafirm. eSoles vision is to become the world’s premier brand name Haflinger/Highlander (Gerda Hoehm) (1999) Chicago, IL...... 800-566-0664 and technological leader in custom footbeds for consumers Boiled wool slippers, latex arch support, felt and leather Fax...... 773-523-3639 seeking superior athletic performance, lifestyle and medical clogs, cork molded footbed. Highlander is Gerda Hoehm’s E-mail ...... [email protected] benefits. eSoles custom footbeds were born with a sporting new high-quality comfort line with a removable footbed. Website ...... www.justinblairco.com heritage that grew out of the passion of a world class athlete Both Haflinger and Highlander are made in Germany. and the ingenuity of a certified pedorthist. New York, NY ...... 212-949-6767 Scottsdale, AZ ...... 480-222-7333 Fax...... 212-949-8833 Fax...... 480-315-1790 E-mail ...... [email protected] E-mail ...... [email protected] Website ...... www.esoles.com Hapad, Inc. (1988) Hapad is a leading manufacturer of 100% natural wool Euro International, Inc. (1997) felt foot products and sports replacement insoles used KLM Laboratories (2006) Preformed insoles, diabetic shoes and materials in different for conservative management of common, painful foot An industry leader in the manufacture of foot orthotics hardnesses, especially for diabetics. complaints. Correctly sized, comfortably skived and adhesive and insoles, specializing in custom orthotics, pre-fabricated Tampa, FL...... 800-378-2480 backed for quick and effective adjustments in the shoe. orthotics, orthotic insoles and orthotic materials. Fax...... 813-246-5998 Bethel Park, PA...... 800-544-2723 Valencia, CA...... 800-556-3668 E-mail ...... [email protected] Fax...... 800-232-9427 Fax...... 800-556-3338 Website ...... www.eurointl.com E-mail ...... [email protected] Email...... [email protected] Website ...... www.hapad.com Website ...... www.klmlabs.com Ever-Flex, Inc. (2008) Ever-Flex is a well-respected manufacturer of fine medical Human Motion NA, LLC (2010) Klogs-USA (2007) foot orthotics. Specialized laboratory technicians in both the Evergreen, CO...... 207-415-1756 Sullivan, MO...... 573-468-5564 United States and United Kingdom precisely form and finish Fax...... 573-468-5560 custom Rx and prefabricated orthotics that are dispensed by E-mail ...... [email protected] healthcare professionals worldwide. We offer a complete line InStride Shoes (2003) of orthotics that have proven successful in the treatment of InStride is a manufacturer of Medicare reimbursable, neuromas, heel spurs, plantar fasciitis, poor posture and other multiple width footwear for diabetics that features the three Kumfs Shoes N.Z., Ltd. (1998) medical problems relating to the foot, ankle, knee and back. layer Custom Fit System. Quality, thoughtfully designed shoes and sandals. Orthotics Taylor, MI...... 734-947-2060 Hillsborough, NJ ...... 866-9-MY-FEET friendly with specialist designed removable contoured Fax...... 734-947-9372 Fax...... 908-359-7434 footbeds. E-mail ...... [email protected] E-mail ...... [email protected] El Dorado Hills, CA...... 530-676-9960 Website ...... www.ever-flex.com Website ...... www.instrideshoes.com Fax...... 530-676-9965 E-mail ...... [email protected] Finn Comfort (1993) J.H. Cook & Sons, Inc. (2004) Website ...... www.kumfs.com Luxury comfort footwear. Men’s and women’s walking Shoe modification components, foot comfort products and shoes, sandals and boots featuring removable/modifiable shoe repair supplies. Products from Aetrex, Spenco, Vibram Landesman Bros., Inc. (2003) orthopedic footbeds. Hand-crafted in Germany. and Soletech. Distributors of foot comfort products, pedorthic, orthopedic Thousand Oaks, CA...... 805-375-0038 Granite Quarry, NC...... 704-279-5568 and wound care supplies. Same day shipping. Fax...... 805-375-0848 Fax...... 704-279-5261 Island Park, NY...... 800-852-8855 E-mail ...... [email protected] E-mail ...... [email protected] Fax...... 516-889-1253 Website ...... www.finncomfort.de E-mail ...... [email protected] Jerry Miller I.D. Shoes, Inc. (1977) Website ...... www.landesmanbros.com Frankford Leather Company, Inc. (1997) Jerry Miller Shoes extensive custom-molded shoemaking Diabetic seamfree socks, foot comfort products, shoes, shoe experience has also been applied to a new family of custom Lord Custom Molded Shoes, Inc. (1994) modification/shoe repair supplies, foam impression kits, specialty AFOs - Buffalo Brace. Both shoes and braces feature state-of- Fashionable custom-molded shoes for men, women, and adhesives and more. Same-day shipping. Products from Apex, the-art CAD technology, high quality glove leather, various children. Guaranteed fit and service. Soletech, Vibram, EVA, Sher, Dryz, etc. Catalogs available. color options and a choice of closure methods. Jerry Miller Shoes and Buffalo Brace. For all walks of life! Bohemia, NY ...... 800-SHOES11 Bensalem, PA...... 800-245-5555 Fax...... 516-471-3090 Fax...... 215-244-4411 Buffalo, NY...... 800-435-0065 MacPherson Leather Company (2005) E-mail ...... [email protected] Fax...... 716-881-0349 Seattle, WA...... 206-328-0855 Website ...... www.frankfordleather.com Websites...... www.jerrymillershoes.com Fax...... 206-328-0859 ...... www.buffalobrace.net E-mail ...... [email protected]
54 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 Product Reference Guide
MacPherson Leather Co. (2005) Pine Tree Orthopedic Lab (2007) MacPherson Leather Company has provided a tradition of As an orthopedic lab, we offer physicians across the nation caring service since the early 1900s. As a generational family high quality leather covered AFO’s (Ankle Foot Orthoses), business, we are committed to providing excellent service custom orthotics, semi-custom orthotics, and diabetic and expertise for all of our customers’ needs. inserts. For more information on a specific product line, As a wholesale and retail company, we offer quality products please visit our website. for saddle and tack, shoe findings, and leather craft trades. New Balance/Aravon (1990) We pride ourselves in manufacturing high quality devices We hope you find what you are looking for on our site and New Balance is a leading manufacturer of technologically using the most durable materials possible. With standard please contact us with any questions you may have. innovative athletic products. five business day turnaround, and exceptional customer Seattle, WA...... 206-328-0855 Boston, MA ...... 617-783-4000 service, it is time to see what PTOL can do for you! FAX...... 206-328-0859 Fax...... 617-783-7050 Livermorefalls, ME...... 207-897-5558 E-mail ...... [email protected] Website ...... www.newbalance.com Fax...... 207-897 1117 Website ...... www.macphersonleather.com E-mail ...... [email protected] Oasis Footwear, LLC (2009) Website ...... www.pinetreeorthpedic.com Miami Leather Company (2001) Oasis Footwear was founded on the principle of prevention, Wholesaler to the orthopedic, prosthetic, retail shoe and wellness, and style through our diabetic shoes and inserts. shoe repair trades. Wide variety of products. We strive to offer the diabetic patients a shoe they will want Miami, FL...... 305-266-8328 to wear. Oasis Footwear is ‘Diabetic Footwear Redefined.’ To Fax...... 305-266-8728 learn more, visit our website today at www.oasisfeet.com. E-mail ...... [email protected] Erie, PA ...... 814-384-7579 Propet USA, Inc. (2000) Website ...... www.miamileather.com Fax...... 814-217-1354 Leading manufacturer in men’s and women’s comfort E-mail ...... [email protected] walking shoes. Available in up to 5 widths, sizes 5-13 in M. J. Markell Shoe Company, Inc. (1973) Website ...... www.oasisfeet.com women’s, 7-17 in men’s. Propet features a vast selection of Medicare A5500 coded footwear with removable orthotics, Men’s, women’s and children’s comfort and orthopedic footwear. secure closure and maximum customization. Yonkers, NY...... 914-963-2258 Kent, WA...... 800-877-6738 Fax...... 914-963-9293 Fax...... 800-597-8668 E-mail ...... [email protected] E-mail ...... [email protected] Website ...... www.markellshoe.com Orthofeet, Inc. (1999) Website ...... www.propetusa.com Manufacturer and distributor of high quality depth-shoes and orthotics. MMAR Medical Group, Inc. (2003) P.W. Minor, Inc. (1968) Distributor of multiple diabetic shoe brands at Northvale, NJ...... 800-524-2845 Footwear products for foothealth. manufacturer-direct wholesale pricing. Other products Fax...... 201-767-6748 include AFO’s, ankle braces and cam walkers. E-mail ...... [email protected] Batavia, NY...... 585-343-1500 Website ...... www.orthofeet.com Fax...... 585-343-1514 Houston, TX...... 800-662-7633 Website ...... www.pwminor.com Fax...... 713-465-2818 E-mail ...... [email protected] PartnerShip (2000) Website ...... www.mmarmedical.com PartnerShip, in cooperation with PFA, offers members-only Quality Outcomes, LLC (2007) discounts and savings on small package shipping with FedEx Quality Outcomes helps remove the stress and worry Mobils by Mephisto (1998) Ground, and on large freight shipments with Yellow Freight. associated with complying with the mandatory Medicare accreditation process. Not just guidance and Extra-depth footwear with a removable footbed and natural Oberlin, OH...... 800-599-2902 recommendations, but the leadership and expertise needed orthopedic support. Fax...... 440-774-2823 to maintain your specific policies and procedures while Franklin, TN ...... 800-775-7852 ensuring your organization continues to comply with Fax...... 615-771-5935 PediFix, Inc. (2001) accreditation requirements. Let Quality Outcomes handle Email...... [email protected] Foot specialists since 1885, PediFix is the only fourth the organization and paperwork burden so you can see more Website ...... www.mephisto.com generation, family-owned business in the pedorthic industry. patients and increase your profits! Choose from more than 150 quality foot treatment products, Fredericksburg, VA...... 800-986-3004 including a unique OTC line guaranteed to generate cash Munro & Company, Inc. (2000) E-mail ...... [email protected] sales, keystone profits and doctor referrals, an assortment Website ...... www.qualityoutcomes.org Hot Springs, AR...... 501-262-6156 of both traditional and exclusive Visco-GEL foot pads and Fax...... 501-262-6165 cushions, new dermatology products, GelStep silicone insoles and orthotics, Diabetic Solutions Socks, PediPlast Remington Products (2000) and more. 15 new products are being introduced this year. Insoles and sheet packages, rigid arch supports, viscoelastic Contact PediFix today for a free color catalog. heel cups, 3/4 and full insoles. Brewster, NY ...... 800-424-5561 Wadsworth, OH...... 330-335-1571 Fax...... 845-277-2851 Fax...... 330-336-9462 E-mail ...... [email protected] E-mail Adress...... [email protected] Website ...... www.pedifix.com Website ...... www.remprod.com Natural Step (2004) Manufacturer of men’s and ladies’ handsewn moccasin extra- Pedors Shoes (1999) Renia GmbH (2001) depth shoes. Available in a large selection of sizes and widths. Orthopedic shoes with a neoprene forefoot. Specially designed adhesives and components for the shoe industry, shoe repair trade, and O & P industry. Jupiter, FL ...... 866-500-7463 Marietta, GA...... 800-750-6729 Fax...... 866-540-7463 Fax...... 800-446-3101 Cologne, Germany...... 49-221-6307990 E-mail ...... [email protected] Email...... [email protected] Fax...... 49-221-63079950 Website ...... www.naturalstepshoes.com Website ...... www.pedors.com E-mail ...... [email protected] Website ...... www.renia.com
Ruby Leather & Orthopedic Company Inc. (1998) Milwaukee, WI...... 414-778-2288 PEL Supply Company (1995) Fax...... 414-778-2047 Wholesale distributor stocks broad selection of finished foot and arch products, materials and tools for fabricating foot orthotics. Cleveland, OH...... 800-321-1264 Fax...... 800-222-6176 E-mail ...... [email protected] Website ...... www.pelsupply.com
Pedorthic Footcare Association • www.pedorthics.org 55 Product Reference Guide
Sole Custom Footbeds (2007) Superfeet Worldwide LLP (2003) Calgary, Alberta, Canada ...... 403-204-0907 Ferndale, WA...... 360-384-1820 Fax...... 604-608-3596 Fax...... 360-384-2724 Web site...... www.yoursole.com E-mail ...... [email protected]
SAS Shoemakers (1992) SureFit, Inc. (2009) SureFit features an expanded line of SureFit branded shoes, Comfort walking shoes for women and men in a wide range popular shoe brands, DME products, and alternate therapies of widths and sizes. for patients with neuropathy. SureFit is a Richie Brace San Antonio, TX...... 210-924-6561 SoleTech, Inc. (1994) provider. Fax...... 210-921-7460 Orthopedic footwear, cushioning and rubber materials, Coral Springs, FL...... 678-455-8872 E-mail ...... [email protected] and adhesives. Fax...... 954-752-8995 Website ...... www.SASshoes.com Salem, MA...... 800-225-2192 E-mail ...... [email protected] Fax...... 978-741-2091 Website ...... www.surefitlab.com STS Company (1997) E-mail ...... [email protected] Website ...... www.soletech.com Resin-impregnated tubular and fitted socks made to take The Compliance Team (2010) foot and ankle impressions for custom shoes and foot/ankle Spring House, PA...... 215-654-9110 orthotic devices. Somnio (2010) Fax...... 215-654-9068 Mill Valley, CA...... 800-787-9097 Somnio is Latin for “dream.” Our mission is to help people E-mail ...... [email protected] Fax...... 415-381-4610 achieve their lifestyle goals and do so while remaining injury E-mail...... [email protected] and pain free. We aren’t just selling shoes; we’re solving Website ...... www.stssox.com problems, and are helping to make some dreams come true along the way. La Selvai Beach, CA...... 831-688-7861 SafeStep (1994) Fax...... 831-688-7683 SafeStep makes it easy to utilize the Medicare Therapeutic E-mail ...... [email protected] Therafirm (A Division of Knit-Rite, Inc.) (1999) Shoe Program by streamlining shoe ordering, document Website ...... www.somniorunning.com Quality medical-grade compression hosiery and diabetic socks. procurement and Medicare billing. Ellerbe, NC ...... 800-562-2701 Milford, CT ...... 866-712-7837 Southern Leather Company (1996) Fax...... 910-652-2438 Fax...... 208-728-0091 7 locations nationwide. The most extensive pedorthic Website ...... www.therafirm.com E-mail...... [email protected] and shoe care/repair inventory in the industry. Inventory Website ...... www.safestep.net includes Apex, Soletech, Eva, Vibram and Acor. Thor-Lo, Inc. (2001) Memphis, TN...... 800-844-6767 Statesville, NC...... 704-872-6522 Sequoia/Comfort Rite (1998) Fax...... 901-946-1059 Fax...... 704-838-6323 Quality comfort footwear in a variety of sizes and widths. E-mail ...... [email protected] New Holstein, WI ...... 800-898-5556 Tru-Mold Shoes, Inc. (1980) Fax...... 920-898-4605 Spira (2004) Tru-Mold Shoes offers a complete line of contemporary, fully El Paso, TX...... 866-838-8640 accommodating custom-molded shoes, including the Thera- Fax...... 915-838-8641 Medic Shoe package – the most flexible, highest value shoe package for Medicare-eligible patients with diabetes. Buffalo, NY...... 800-843-6653 Fax...... 716-881-0406 E-mail ...... [email protected] Website ...... www.trumold.com Shoe Systems Plus, Inc. (2003) UCO International (1987) Complete line of orthotic and prosthetic equipment Sroufe Healthcare Products LLC (2006) Materials, tools, and lab equipment for production of including finishers/grinders, vacuum pans, pumps, presses, Custom diabetic inlays, casting foam boxes, pre-fabricated custom orthotics. Comprehensive line of pre-molded foot industrial sewing machines, fume busters and more. orthotics and orthopedic softgoods. orthosis and Quick-Sil silicone system. Goshen, NY...... 800-354-6278 Ligonier, IN...... 260-894-4171 Wheeling, IL ...... 800-541-4030 Fax...... 845-291-7097 Fax...... 260-894-4092 Fax...... 847-541-4144 E-mail ...... [email protected] E-mail ...... [email protected] E-mail ...... [email protected] Website ...... www.shoesystemsplus.com Website ...... www.sroufe.com Web site...... www.ucointernational.com Vibram-Quabaug Corporation (1998) Quabaug Corporation is the U.S. manufacturer of Vibram soling products and Barge adhesives. Pedorthic Footcare Association North Brookfield, MA...... 508-867-7731 Fax...... 508-867-4600 nd E-mail ...... [email protected] 52 Website ...... http://www.vibram.us Walkwell International Laboratories (2006) A nnual Symposium Boise, ID...... 208-343-8907 & Exhibition E-mail ...... [email protected] Xsensible Footwear North America, Ltd. (2002) Patented stretchable leather, nubuck and fabric footwear in many styles. All stretchable materials are breathable and November 10-13, 2011 wick moisture away from the foot. Albuquerque Convention Center Vancouver, British Columbia Canada...... 866-887-4605 Albuquerque, New Mexico Fax...... 866-328-4842 E-mail ...... [email protected] Website ...... http://www.stretchwalker.com
56 CURRENT PEDORTHICS • November/December 2010 • Volume 42, Issue 6 W R 1 22 6W B
Shoes that Fit Better PERFORM BETTER
Performance is our heritage, commitment, and the force behind New Balance Total Fit. New Balance personally selects dealers with the proper expertise and an extensive selection to ensure you get the right shoe and right fit for your active lifestyle. Find a Procare dealer near you now: newbalance.com/shop/procare
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Current_Pedorthics_FA10.indd 2 8/20/10 11:16 AM bodyworks is designed to help transfer pressure and force away from your feet towards areas of your body that benefit from stimulation such as your calves, hamstrings and gluteal folds.
aetrex.com/lifestyles