Foot care training

Tutti · Jan 26, 2004

I am wondering if anyone bills medicare/medicaid for foot care? In the past I've been told that only Doctors can do this. I also once heard that a nurse can bill for services if there is a Doctor within reach. I am in a position where billing for foot care that I do may really save me and need any information I can get. Please, if anyone has any information, I would be forever grateful!

Thank You,

~Tutti~

guest*** · Jan 26, 2004

Foot care is only covered by medicare in very "sick" feet. A person has to have severe PVD, no pulses, or a high risk diabetic with peripheral neuropathy. Infected, painful fungal nails are also covered.

http://hiicap.state.ny.us/medicare/foot_care.htm

This site explains in detail. You have to have a medicare provider number to bill and only MD's, DPM's or NP's can get those. If you work for one of these people and they are on site and the patient qualifies, then the provider can bill medicare.

There are a few obscure insurance policies that cover routine foot care. I have had patients pay me, then send my invoice to their insurance company and get reimbursement. Otherwise, it is strictly cash or check at my company.

Hope this helps.

guest*** · Jan 29, 2004

I spoke with 2 nurses from the certifiying board at the WOCN the other day and got some good news. This certification process is going to be open to Associate Degree nurses. I was first informed several years ago, when this was just an idea, that it would be for Bachelor Degree nurses and higher. Apparently they did a survey and found that most of the nurses doing foot care are A.S. nurses. So this is really good news. Now the LVN's/L.P.N.s need to go to their governing bodies and see how to get something going for them. It is very exciting to see this finally happening. It looks like I may be one of the nurses on the Exam Committee for this process and I will find out in a few weeks. I will keep you posted on any interesting developments. I do have one insight. I think that the use of dremel grinders is going to be very discouraged. I am going to advocate for the electric nail filing systems, something actually made with nails in mind and not craft projects. They are great tools, safe and with many different bits that can be sterilized.

Tutti · Jan 30, 2004

You have been so great with giving us information. Thank you. I am disappoionted that I won't be able to take this course, I will admit. But that's okay. I'm happy for you and I'm sure you will be a great resource for helping with the exam. I know there is so much controversy with using the dremel. Lots of my Patients want me to use the dremel. I purchased a special burr especially for foot care that Podiatrists use. Any thoughts on that? It can be soaked with disinfectant. I've used one of the pedicure electric files, but it doesn't do the job in some of the tougher cases. Keep us posted for sure, Laura! This is so exciting! If I only could, I would run out and get my A.S. degree immediately! Keep up the good work!

:) Tutti

hoolahan, ASN, RN · Jan 30, 2004

Foot Care for Salon Professionals by Dr. Oscar Mixx published by Malady Press ( I think) Look on Amazon.com. Great book, should be called Foot Care for Health Care Professionals. WAY beyond the scope of practice for pedicurists. I took an 8 hour class by him that was great and was given at a trade show for the Cosmetology Professionals in Sacramento last year. Good luck!

I got this book, and you are absolutely right, it should be called Foot Care for HC Pro's. It is excellent!! Thank you for the recommendation. The author is a pod who just wants everyone to have good feet, and his philosophy, much like Lois Jean's, is that if he can spread the word to anyone who cares for feet, and hone their assessment skills, he will be getting them a step in the right direction, pun intended! I would have loved to see this guy in person, he seems like a wonderful doc, generous with his knowledge.

guest*** · Jan 30, 2004

Glad you liked the book. It is one of the best. The only error I found in it is in the part that addresses capillary refill time. It says it should be under 30 seconds and that is a typo! I think he meant 3 seconds. I use 5 seconds as my cut off for referral to apodiatrist.

Dr. Mix is an incredibly nice guy. Too bad he is nearing retirement. He could be a great asset to foot care nursing workshops. I was fortunate enough to take an 8 hour workshop with him. Someday I may have my own classes going. We will see. Right now I am inundated with my current business.

Also, I just found on the WEB that Dremel has now come out with a more sophisticated tool, an electric system, designed for nails. This is a different drill than their old battery operated tool. The battery operated one is now being packaged and marketed toward nail professionals as opposed to the crafter. However, it is the same tool. You can see some of these new files I am talking about by going down to your local manicurist. I have 3 different files ranging from $300 to my $1750.00 Orthofex that is made in Holland and has a vaccum near the bit. The electric nail filing systems are much better. They are more comfortable for the client. It is worth the investment!

http://www.aefm.org/cgibin/aefm.cgi

That site has more information on those systems.

guest*** · Feb 1, 2004

Check out this site by the American Orthopaedic Foot and Ankle Society. They have an anual COMPLETE FOOT CARE COURSE that targets all health professionals dealing with feet and has a special tract for nurses! It is a 3 day course, May 14-16 in New Orleans and I am going to go. I have always wanted to attend one of their conferences. MD's and orthopedic surgeons are much more nurse friendly than podiatrists, generally speaking. So check it out. If anyone ends up going, let me know and we can meet for lunch!

http://aofas.org/cde.cfm?event=34577

adrienurse, LPN · Feb 1, 2004

Wondering how a 3 day conference can be considered a complete course, when my course involves 44 hours of in class lectures and a practical componant.

guest*** · Feb 2, 2004

adrienurse,

You are right. Complete Foot Course is sort of false advertising. However, it does look like a good course. It is put on by MD's and RN's so there is not the competative factor like the Seattle Foot Course. It is slim pickins for foot care courses in the states and this looks like one of the better ones I have seen advertised. These types of courses are great for networking. And there is always something new out there in the foot care world. It would be a good place for nurses interested in this field to go. But we definetly need a REAL complete foot course with lots of hands on. Where is your course? Did you teach it or attend it?

Tutti · Feb 6, 2004

I have a question I am hoping I can get some help with. I need to make a consent form for my foot care clients. Do any of you use one? I need to know what information I need to put on there. And if the Patient cannot sign for himself, and there is not a family member present, what then?

Thank you in advance!

Tutti

guest*** · Feb 6, 2004

Tutti

Am going out of town for the week end but will post you what I am using. However I have no idea how legal it is. I used part of a consent form that my Canadian nurse friend uses and added my own part about also allowing me to photograph for teaching purposes. So check again, I should have it posted by Tues. It might be a start anyway. Probably consulting a lawyer would be the surest way to do this, but expensive.

Tutti · Feb 7, 2004

Thanks! I appreciate it! You're the best!

~Tutti~