Volume 18 - Issue 9 - September 2005
Treatment Dilemmas »
An athletic, 35 year-old male presents to the office four months after suffering an ankle sprain while playing soccer. In spite of a period of immobilization and a course of physical therapy, he has had continued pain and stiffness localized to the ankle joint. He has been wearing a lace-up ankle brace, icing the ankle and taking OTC NSAIDs.
A physical examination reveals mild tenderness upon palpation to the ankle joint line but there is no significant pain along the medial or lateral collateral ligaments. He has a negative anterior drawer. Routine X-ra
Getting a denial for claims is, at best, upsetting for both the doctor and staff. Often, the doctor sees this in a negative light. If the dollar amount in question is small, he or she may totally disregard it, believing it is “not worth it” to appeal. When repeated problems involving specific CPT or ICD-9 codes occur, DPMs sometimes select alternative coding choices, which may not be the best option either.
Instead of looking at a claim denial as a defeat, try to look at it as an educational opportunity. Unless one understands the reason for the deni
Continuing Education »
Increased plantar foot pressure is a leading cause of ulceration in the diabetic population.1 Healing these ulcers requires adequate blood supply, control of infection, excellent wound care and offloading or pressure redistribution of the ulcerative area.2-16 Out of all these factors, offloading presents a particularly unique challenge in treating chronic wounds. As diabetic foot care has evolved over the years, podiatrists have used numerous approaches including complete bed rest, cutout felt pads and total contact casting to offload these wounds.3
Editor's Perspective »
Sports medicine reportedly drives a large number of folks to study podiatric medicine. However, it does not appear to be much of a priority at the majority of the podiatry schools. Only two schools offer a semester course in sports medicine in the third year. Virtually no residency program devotes significant time to sports medicine, according to one prominent podiatrist with an active sports medicine practice.
A professor at one of the colleges bluntly sums up her school’s commitment to sports medicine: “We truck in an expert every couple of years t
Diabetes Watch »
Skin ulceration of the lower extremity affects millions of people in the United States alone and may be secondary to a myriad of etiologies including pressure, metabolic, trauma, venous, arterial and diabetic neuropathy.1 The medical, psychosocial and financial impacts imposed by lower extremity ulcerations are tremendous. The attributable cost for the treatment of chronic lower extremity ulcerations has been estimated to be as high as $3.6 billion dollars per year.2 Medicare expenditures for lower extremity ulcer patients were, on average, three times h
As a fourth-year podiatry student in 1974, I decided to start my practice debt-free. As a student, I heard horror stories about young DPMs going $60,000 into debt to open their first office. In 1974, $60,000 would give you a posh office with state-of-the-art equipment and plenty extra to live on before the revenue started pouring in.
I heard stories about young podiatrists who ended up falling behind and losing everything before they completed the first year. Our current graduates are now toughened by the overwhelming burden of six-figure student loans an