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New Patient
O.V. NP - Expanded - 99202
New Pt. Evaluation - 99203
Level 4
NP Referral Consult - 99243
Established Patient
O.V Established Pt. - 99212
Eval.-Established Pt. 99213
O.V. Detailed/Comprehensive 99214
Orthotics Made
Procedures
Wound Debridment
Debridement-Superficial (Eczema) - 11000
Debridement Ulcer up 20 sq cm - 97597
Debridement Ulcer greater than 20 sq cm - 97598
Debridement, Subq tissue 1st 20 sq cm - 11042
Debridement: Subq tissue each addt'l 20 cm - 11045
Debridement Muscle and/or Fascia - 11043
Debridement Muscle and/or Fascia ea addt'll sq cm - 11046
Debridement to muscle or bone - 11044
Shave/Biopsy
Excise-Benign les-.05 cm or less (leg) - 11300
Shaved Lesion - 1.1 to 2.0 cm (leg) - 11302
Excise Benign Les. -1.1-2.0 cm (leg) - 11302
Excise-Benign Les.-0.5 cm or$ <(ft) - 11305
Excise-Benign Les.-0.6 to 1.0 cm (ft) - 11306
Excise-Benign Les.-1.1 - 2.0 cm (ft) - 11307
Biopsy of skin - biopsy only not excision - 11100
Nails/Callus/Warts
Avulsion (No Phenol) - 11730
Avulsion-Nail$(add'l Nail Plates) No Phenol - 11732
Evac. Subungal Hematoma - 11740
Matrix- with Phenol - 11750
Wart benign lesion1-14 - 17110
Chemosurgery benign lesion 15+ - 17111
Hyperkeratotic Lesions Cut 1 lesion - 11055
Cut 2-4 - 11056
Cut >4 - 11057
Debridement of 1-5 Toenails 11720
LEFT Digits
• • •
RIGHT Digits
• • •
Debridement of 6-10 Toenails 11721
LEFT Digits
• • •
RIGHT Digits
• • •
Trim Dystrophic Nails (1-10) - G0127
LEFT Digits
• • •
RIGHT Digits
• • •
Silver Nitrate Application - 17250
Injections
Ultrasound guided -76942
Left
Right
Plantar fascia
Plantar fascia
Neuroma
Neuroma
Tarsal Tunnel
Tarsal Tunnel
Ganglion cyst Left
Ganglion cyst right
Injection Therapies -Tendon/Ligament - 20550
Left Plantar fascia
Right Plantar fascia
Joint - small - 20600
Joint - large (ankle) - 20605
Nerve - steroid inj - 64450
Nerve - sclerosing agent - 64640
Ganglion cyst aspiration
Nerve - plantar digital - 64455
Injectibles - J1100
Injectibles - J3301
Injectibles - J1030
Imaging Modalites
Ultrasound Limited LT
Ultrasound Limited RT
Ultrasound Complete LT
Ultrasound Complete RT
Xray complete left foot
Xray complete right foot
Xray partial foot left
Xray partial right foot
Xray Ankle complete left
Xray ankle complete right
Xray partial ankle left
xray partial ankle right
ABI
Casting/Strapping/Unnaboot
Total Contact Casting - Q4038
Total Contact Casting - 29445
Short Leg Casting RT - 29425
Short Leg Casting LT - 29425
Unna Boot-Per MCR RT - 29581
Unna Boot-Per MCR LT - 29581
Strapping, Foot/Ankle - 29540
Strapping, Toe - 29550
Fracture Management
Chemical Burn Mgmt - 16020
Fx Mgmt (no manip) calc - 28400
Fx Mgmt (no manip) talus - 28430
Fx Mgmt (no manip) tarsal - 28450
Fx Mgmt (no manip) meta - 28470
Fx Mgmt (no manip) sesam - 28530
Problem List
Muscle/Skeletal
Pain - Lower Leg Left - M79.66
Pain - Lower Leg Right - M79.66
Pain - Foot Left - M79.67
Pain - Foot Right - M79.67
Pain - Toe(s) Left - M79.67
Pain - Toe(s) Right - M79.67
Walking Difficulty, Ankle, Foot - R26.2
Weakness, muscle - M62.81
Gait. Abnormality - R26.9
Fibromalgia - M79.7
Amputations
Amputations - Toe - Z89.42
Amputations - Hallux - Z89.41
Amputations - Foot - Z89.43
Amputations - Ankle - Z89.44
Amputations - BKA - Z89.51
Amputations - AKA - Z89.61
Joints
Arthritis
Arthritis, Gouty Arthropathy Right - M10.07
Arthritis, Gouty Arthropathy Left - M10.07
Arthritis, Rheumatoid Right - M06.87
Arthritis, Rheumatoid Left - M06.87
Arthropathy, Unspec., Ankle/Foot - M12.9
Osteoarthosis, Post-Traumatic - M19.92
Osteoarthritis, Secondary - M19.93
Arthritis Foot/Ankle Left
Arthritis Foot/Ankle Right
Hallux Rigids left
Hallux Rigids Right
Contracture/Stiffness/Bursitis
Ankle Joint Contracture Right - M24.57
Ankle Joint Contracture Left - M24.57
Joint Instability Right - M24.87
Joint Instability Left - M24.87
Joint Pain, Unspc. Ankle/Foot Right - M25.57
Joint Pain, Unspc. Ankle/Foot Left - M25.57
Bursitis Right - M77.5
Bursitis Left - M77.5
Joint Stiffness - Ankle Right - M25.67
Joint Stiffness - Ankle Left - M25.67
Joint Stiffness - Foot Right - M25.67
Joint Stiffness - Foot Left - M25.67
Sinus Tarsi Syndrome Right - M25.57
Sinus Tarsi Syndrome Left - M25.57
Sesamoiditis - M77.8
Deformity
Hallux Abducto Valgus Right - M20.1
Hallux Abducto Valgus Left - M20.1
Hallux Limitus Right - M20.2
Hallux Limitus Left - M20.2
Hammertoe, Other, Acqrd Right - M20.4
Hammertoe, Other, Acqrd Left - M20.4
Tailor's Bunion, Bunionette Right - M21.6X
Tailor's Bunion, Bunionette Left - M21.6X
Pes Cavus Foot Deformity Right - M21.6X
Pes Cavus Foot Deformity Left - M21.6X
Pes Planus, Acquired Right - M21.4
Pes Planus, Acquired Left - M21.4
Pes Planus, Congenital Right - Q66.5
Pes Planus, Congenital Left - Q66.5
Charcot Arthropathy Right - M14.67
Charcot Arthropathy Left - M14.67
Leg Length, Unequal, Acqrd - Fibula Right - M21.76
Leg Length, Unequal, Acqrd - Fibula Left - M21.76
Leg Length, Unequal, Acqrd - Tibia Right - M21.76
Leg Length, Unequal, Acqrd - Tibia Left - M21.76
Metatarsalgia, Enthesopathy Right - M77.4
Metatarsalgia, Enthesopathy Left - M77.4
Plantar fixed Metartsl (unspdDfmty) - Q66.89
Elevated 1s ray Left
Elevated 1st ray right
Met- Adductus Left
Met- Adductus right
Exostosis - Calc. Spur Right - M77.3
Exostosis - Calc. Spur Left - M77.3
Tendonitis/Fascitis
Achilles Tendonitis (Bursitis) Right - M76.6
Achilles Tendonitis (Bursitis) Left - M76.6
Anterior Tibial Tendonitis Right - M76.81
Anterior Tibial Tendonitis Left - M76.81
Capsulitis, Tendinitis, NOS - M77.9
Apophysitis, Epiphysits; Foot - M92.8
Equinus Right - M21.6X
Equinus Left - M21.6X
Peroneal Tendonitis Right - M76.7
Peroneal Tendonitis Left - M76.7
Plantar Fasciitis/Plantar Fibroma - M72.2
Exostosis NOS (BneSpr, SbU ngl) - M77.9
PTTD Right - M76.82
PTTD Left - M76.82
Ganglion, Joint Right - M67.47
Ganglion, Joint Left - M67.47
Tumors
Neoplasm-unknown origin - D49.2
Neoplasm-skin, Benign Right - D23.7
Neoplasm-skin, Benign Left - D23.7
Neoplasm, Soft Tissue Right - D21.2
Neoplasm, Soft Tissue Left - D21.2
Neoplasm - bone cyst/tumor Right - D16.3
Neoplasm - bone cyst/tumor Left - D16.3
Osteomyelitis
Osteomyelitis - Acute - Foot/Ankle Right - M86.17
Osteomyelitis - Acute - Foot/Ankle Left - M86.17
Osteomyelitis - Chronic F/A Left - M86.672
Osteomyelitis - Chronic F/A Right - M86.671
Osteomyelitis - Chronic w/ Drainage - F/A Right - M86.47
Osteomyelitis - Chronic w/ Drainage - F/A Left - M86.47
Trauma (Requires 7th character.)
Contusion - Ankle Right - S90.0
Contusion - Ankle Left - S90.0
Contusion - Foot Right - S90.3
Contusion - Foot Left - S90.3
Contusion - Great Toe w/o Nail Damage Right - S90.11
Contusion - Great Toe w/o Nail Damage Left - S90.11
Contusion - Lesser Toe w/o Nail Damage Right - S90.12
Contusion - Lesser Toe w/o Nail Damage Left - S90.12
Contusion - Great Toe w/ Nail Damage Right - S90.21
Contusion - Great Toe w/ Nail Damage Left - S90.21
Contusion - Lesser Toe w/ Nail Damage Right - S90.22
Contusion - Lesser Toe w/ Nail Damage Left - S90.22
Foreign Body-Subcutaneous (No 7th) - L92.3
Foreign Body-Superficial-Toe Right great toe - S90.45
Foreign Body-Superficial-Toe Left great toe - S90.45
Foreign Body-Superficial-Toe Right lesser toe(s) - S90.45
Foreign Body-Superficial-Toe Left lesser toe(s) - S90.45
Foreign Body-Superficial-Foot Right - S90.85
Foreign Body-Superficial-Foot Left - S90.85
Fracture - Ankle
Displaced fracture of medial malleolus Right - S82.5
Displaced fracture of medial malleolus Left - S82.5
Non-displaced fracture of medial malleolus Right - S82.5
Non-displaced fracture of medial malleolus Left - S82.5
Displaced fracture of lateral malleolus Right - S82.6
Displaced fracture of lateral malleolus Left - S82.6
Non-displaced fracture of lateral malleolus Right - S82.6
Non-displaced fracture of lateral malleolus Left - S82.6
Fracture - Calcaneus
Displaced fracture of body of calcaneus Right - S92.01
Displaced fracture of body of calcaneus Left - S92.01
Non-displaced fracture of body of calcaneus Right - S92.01
Non-displaced fracture of body of calcaneus Left - S92.01
Displaced fracture of anterior process Right - S92.02
Displaced fracture of anterior process Left - S92.02
Non-displaced fracture of anterior process Right - S92.02
Non-displaced fracture of anterior process Left - S92.02
Displaced avulsion fracture of tuberosity Right - S92.03
Displaced avulsion fracture of tuberosity Left - S92.03
Non-displaced avulsion fracture of tuberosity Right - S92.03
Non-displaced avulsion fracture of tuberosity Left - S92.03
Displaced fracture of tuberosity Right - S92.04
Displaced fracture of tuberosity Left - S92.04
Non-displaced fracture of tuberosity Right - S92.04
Non-displaced fracture of tuberosity Left - S92.04
Displaced extraarticular fracture Right - S92.05
Displaced extraarticular fracture Left - S92.05
Non-displaced extraarticular fracture Right - S92.05
Non-displaced extraarticular fracture Left - S92.05
Displaced intraarticular fracture Right - S92.06
Displaced intraarticular fracture Left - S92.06
Non-displaced intraarticular fracture Right - S92.06
Non-displaced intraarticular fracture Left - S92.06
Fracture - Phalanx
Displaced fracture of proximal phalanx of great toe Right - S92.41
Displaced fracture of proximal phalanx of great toe Left - S92.41
Non-displaced fracture of proximal phalanx of great toe Right - S92.41
Non-displaced fracture of proximal phalanx of great toe Left - S92.41
Displaced fracture of distal phalanx of great toe Right - S92.42
Displaced fracture of distal phalanx of great toe Left - S92.42
Non-displaced fracture of distal phalanx of great toe Right - S92.42
Non-displaced fracture of distal phalanx of great toe Left - S92.42
Displaced fracture of proximal phalanx of lesser toe Right - S92.51
Displaced fracture of proximal phalanx of lesser toe Left - S92.51
Non-displaced fracture of proximal phalanx of lesser toe Right - S92.51
Non-displaced fracture of proximal phalanx of lesser toe Left - S92.51
Displaced fracture of medial phalanx of lesser toe Right - S92.52
Displaced fracture of medial phalanx of lesser toe Left - S92.52
Non-displaced fracture of medial phalanx of lesser toe Right - S92.52
Non-displaced fracture of medial phalanx of lesser toe Left - S92.52
Displaced fracture of distal phalanx of lesser toe Right - S92.53
Displaced fracture of distal phalanx of lesser toe Left - S92.53
Non-displaced fracture of distal phalanx of lesser toe Right - S92.53
Non-displaced fracture of distal phalanx of lesser toe Left - S92.53
Fracture - Metatarsal
Displaced fracture of first metatarsal bone Right - S92.31
Displaced fracture of first metatarsal bone Left - S92.31
Non-displaced fracture of first metatarsal bone Right - S92.31
Non-displaced fracture of first metatarsal bone Left - S92.31
Displaced fracture of second metatarsal bone Right - S92.32
Displaced fracture of second metatarsal bone Left - S92.32
Non-displaced fracture of second metatarsal bone Right - S92.32
Non-displaced fracture of second metatarsal bone Left - S92.32
Displaced fracture of third metatarsal bone Right - S92.33
Displaced fracture of third metatarsal bone Left - S92.33
Non-displaced fracture of third metatarsal bone Right - S92.33
Non-displaced fracture of third metatarsal bone Left - S92.33
Displaced fracture of fourth metatarsal bone Right - S92.34
Displaced fracture of fourth metatarsal bone Left - S92.34
Non-displaced fracture of fourth metatarsal bone Right - S92.34
Non-displaced fracture of fourth metatarsal bone Left - S92.34
Displaced fracture of fifth metatarsal bone Right - S92.35
Displaced fracture of fifth metatarsal bone Left - S92.35
Non-displaced fracture of the fifth metatarsal bone Right - S92.35
Non-displaced fracture of the fifth metatarsal bone Left - S92.35
Sprains
Rupture, Lower Leg (No 7th) Right - M66.86
Rupture, Lower Leg (No 7th) Left - M66.86
Ankle Sprain/Rupture
Rupture, Ankle/Foot (No 7th) Right - M66.87
Rupture, Ankle/Foot (No 7th) Left - M66.87
Sprain-Ankle-Calcaneofib. Ligament Right - S93.41
Sprain-Ankle-Calcaneofib. Ligament Left - S93.41
Sprain-Ankle-Deltoid Ligament Right - S93.42
Sprain-Ankle-Deltoid Ligament Left - S93.42
Sprain-Ankle-Tibiofib. Ligament Right - S93.43
Sprain-Ankle-Tibiofib. Ligament Left - S93.43
Midfoot
Sprain-Foot-Tarsal Ligament Right - S93.61
Sprain-Foot-Tarsal Ligament Left - S93.61
Sprain-Foot-Tarsometatarsal Ligament Right - S93.62
Sprain-Foot-Tarsometatarsal Ligament Left - S93.62
Sprain-Foot-Other Part Right - S93.69
Sprain-Foot-Other Part Left - S93.69
Forefoot
Sprain-Toe-Metatarsophalangeal Joint Right great toe - S93.52
Sprain-Toe-Metatarsophalangeal Joint Left great toe - S93.52
Sprain-Toe-Metatarsophalangeal Joint Right lesser toe(s) - S93.52
Sprain-Toe-Metatarsophalangeal Joint Left lesser toe(s) - S93.52
Sprain F/U
Rupture, Lower Leg (No 7th) Right - M66.86
Rupture, Lower Leg (No 7th) Left - M66.86
Ankle Sprain/Rupture
Rupture, Ankle/Foot (No 7th) Right - M66.87
Rupture, Ankle/Foot (No 7th) Left - M66.87
Sprain-Ankle-Calcaneofib. Ligament Right - S93.41
Sprain-Ankle-Calcaneofib. Ligament Left - S93.41
Sprain-Ankle-Deltoid Ligament Right - S93.42
Sprain-Ankle-Deltoid Ligament Left - S93.42
Sprain-Ankle-Tibiofib. Ligament Right - S93.43
Sprain-Ankle-Tibiofib. Ligament Left - S93.43
Midfoot
Sprain-Foot-Tarsal Ligament Left - S93.61
Sprain-Foot-Tarsal Ligament Right - S93.61
Sprain-Foot-Other Part Left - S93.69
Sprain-Foot-Other Part Right - S93.69
Forefoot
Sprain-Toe-Metatarsophalangeal Joint Left great toe - S93.52
Sprain-Toe-Metatarsophalangeal Joint Right great toe - S93.52
Sprain-Toe-Metatarsophalangeal Joint Left lesser toe(s) - S93.52
Sprain-Toe-Metatarsophalangeal Joint Right lesser toe(s) - S93.52
Dermatological Skin
Abscess - Foot Right - L02.61
Abscess - Foot Left - L02.61
Abscess - Lower Limb Right - L02.41
Abscess - Lower Limb Right - L02.41
Atopic Dermatitis-Other - L20.81
Blister - Nonthermal - Great Toe (7th) Right - S90.42
Blister - Nonthermal - Great Toe (7th) Left - S90.42
Blister - Nonthermal - Lesser Toe (7th) Right - S90.42
Blister - Nonthermal - Lesser Toe (7th) Left - S90.42
Blister - Nonthermal - Ankle (7th) Right - S90.52
Blister - Nonthermal - Ankle (7th) Left - S90.52
Blister - Nonthermal - Foot (7th) Right - S90.82
Blister - Nonthermal - Foot (7th) Left - S90.82
Bromhidrosis - L75.0
Cellutitis - Toe Right - L03.03
Cellutitis - Toe Left - L03.03
Cellutitis-Abscess-Foot/Lower Leg Right - L03.11
Cellutitis-Abscess-Foot/Lower Leg Left - L03.11
Chemical Burn - Toe (7th) - T81.31X
Cyst, Inclusion; Keratin Cyst - L72.0
Degenerative/Painful Fissures - L98.8
Dyshydrotic Eczema - L30.1
Hyperhydrosis - L74.513
Kertatoderma, Acquired - L85.1
Onchogryphosis - L60.2
Onchomycosis - B35.1
Onychocryptosis - L60.0
Pyogenic Granuloma - L98.0
Scar NOS. Clcatrix. Fibrosis - L90.5
Tinea Pedis - B35.3
Corn and Callus
Ulceration
Non-Pressure Ulcer (Limited to breakdown of skin.) - Right - L97.511
Non-Pressure Ulcer (Limited to breakdown of skin.) - Left - L97.521
Pressure Ulcerations
Pressure Ulcer - Right Ankle
Stage 1 - L89.511
Stage 2 - L89.512
Stage 3 - L89.513
Stage 4 - L89.514
Pressure Ulcer - Left Ankle
Stage 1 - L89.521
Stage 2 - L89.522
Stage 3 - L89.523
Stage 4 - L89.524
Pressure Ulcer - Right Heel
Stage 1 - L89.611
Stage 2 - L89.612
Stage 3 - L89.613
Stage 4 - L89.614
Pressure Ulcer - Left Heel
Stage 1 - L89.621
Stage 2 - L89.622
Stage 3 - L89.623
Stage 4 - L89.624
Pressure Ulcer - Other Site
Stage 1 - L89.891
Stage 2 - L89.892
Stage 3 - L89.893
Stage 4 - L89.894
NON-PRESSURE CHRONIC ULCERATIONS
Right Calf
Limited to breakdown of skin - L97.211
With fat layer exposed - L97.212
With necrosis of muscle - L97.213
With necrosis of bone - L97.214
Right Heel/Midfoot
Limited to breakdown of skin - L97.411
With fat layer exposed - L97.412
With necrosis of muscle - L97.413
With necrosis of bone - L97.414
Right Ankle
Limited to breakdown of skin - L97.311
With fat layer exposed - L97.312
With necrosis of muscle - L97.313
With necrosis of bone - L97.314
Right (Other Part Of Foot)
Limited to breakdown of skin - L97.511
With fat layer exposed - L97.512
With necrosis of muscle - L97.513
With necrosis of bone - L97.514
Right (Other Part Of Lower Leg)
Limited to breakdown of skin - L97.811
With fat layer exposed - L97.812
With necrosis of muscle - L97.813
With necrosis of bone - L97.814
Left Calf
Limited to breakdown of skin - L97.221
With fat layer exposed - L97.222
With necrosis of muscle - L97.223
With necrosis of bone - L97.224
Left Heel/Midfoot
Limited to breakdown of skin - L97.421
With fat layer exposed - L97.422
With necrosis of muscle - L97.423
With necrosis of bone - L97.424
Left Ankle
Limited to breakdown of skin - L97.321
With fat layer exposed - L97.322
With necrosis of muscle - L97.323
With necrosis of bone - L97.324
Left (Other Part Of Foot)
Limited to breakdown of skin - L97.521
With fat layer exposed - L97.522
With necrosis of muscle - L97.523
With necrosis of bone - L97.524
Left (Other Part Of Lower Leg)
Limited to breakdown of skin - L97.821
With fat layer exposed - L97.822
With necrosis of muscle - L97.823
With necrosis of bone - L97.824
Venus Ulceration
Venous Ulcer - Left - Calf - I83.022
Venous Ulcer - Left - Ankle - I83.023
Venous Ulcer - Left - Heel/Midfoot - I83.024
Venous Ulcer - Right - Calf - I83.012
Venous Ulcer - Right - Ankle - I83.013
Venous Ulcer - Right - Heel/Midfoot - I83.014
Venous Stasis Dermatitis/Inflammation Right - I83.1
Venous Stasis Dermatitis/Inflammation Left - I83.1
Verrucae - B07.9
Xerosis - L85.3
Neurological
Ataxia - R26.0
Cerebral Palsy - G80.9
Charcot Marie Tooth - G60.0
Complex Regional Pain Syndrome Right - G90.52
Complex Regional Pain Syndrome Left - G90.52
Entrapment Neuropathy - G58.9
Foot Drop Right - M21.37
Foot Drop Left - M21.37
Neuroma, LesnPlantrNrv (Morton) Right - G57.6
Neuroma, LesnPlantrNrv (Morton) Left - G57.6
Paraplegia - Complete - G82.21
Paraplegia - Incomplete- G82.22
Peripheral Neuropathy - G60.9
Restless Leg Syn. - G25.81
Tarsal Tunnel Syndrome Right - G57.5
Tarsal Tunnel Syndrome Left - G57.5
Miscellaneous
Drug Therapy/Pain Management - Z79.897
Ancillary Services
Ankle-2 views 73600 Foot-2 views - 73620t-3 views - 73630
Ankle-3 views 73610 Foot-3 views - 73630
Calcaneal Axial-2 views - 73650
Fluoroscopy- Not MCD Cov'd - 76000
Ultrasound Extremity Complete - 76881
Ultrasound Ext, Anatomic Specific - 76882
ABI - Vascular Study - 93923
LE Venous Study - 93965
Diabetes
No Complications - E11.9
w/Neuropathy - NIDDM - E11.42
w/Neuropathy - IDDM - E10.42
w/Foot Ulceration - NIDDM - E11.621
w/Foot Ulceration - IDDM - E10.621
w/Other Skin Ulcer - NIDDM - E11.622
w/Other Skin Ulcer - IDDM - E10.622
w/ PVD/Gangrene - E11.52
W/ PVD w/o Gangrene - E11.51
Vascular Diseases
No Complications - I73.89
Claudication Right - I70.21
Claudication Left - I70.21
Claudication Bilateral - I70.21
w/Rest Pain Right - I70.22
w/Rest Pain Left - I70.22
w/Rest Pain Bilateral - I70.22
w/Ulceration Right - Calf - I70.232
w/Ulceration Right - Ankle - I70.233
w/Ulceration Right - Heel/Midfoot - I70.234
w/Ulceration Left - Calf - I70.242
w/Ulceration Left - Ankle - I70.243
w/Ulceration Left - Heel/Midfoot - I70.244
w/Gangrene Right - I70.26
w/Gangrene Left - I70.26
w/Gangrene Bilateral - I70.26
Raynauds w/o Gangrene - I73.00
Raynauds w/ Gangrene - I73.01
Buerger's - I73.01
Venous Disease
Edema - R60.1
Chronic Venous Insufficiency - I87.2
CVI w/o Complications Right - I87.30
CVI w/o Complications Left - I87.30
CVI w/o Complications Bilateral - I87.30
CVI w/ Ulceration Right - I87.31
CVI w/ Ulceration Left - I87.31
CVI w/ Ulceration Bilateral - I87.31
CVI w/ Inflammation Right - I87.32
CVI w/ Inflammation Left - I87.32
CVI w/ Inflammation Bilateral - I87.32
CVI w/ Ulcer & Inflam. Right - I87.33
CVI w/ Ulcer & Inflam. Left - I87.33
CVI w/ Ulcer & Inflam. Bilateral - I87.33
Lymphadema - I89.0
Venous Ulcer - Right - Calf - I83.012
Venous Ulcer - Right - Ankle - I83.013
Venous Ulcer - Right - Heel/Midfoot - I83.014
Venous Ulcer - Left - Calf - I83.022
Venous Ulcer - Left - Ankle - I83.023
Venous Ulcer - Left - Heel/Midfoot - I83.024
Plan
Conservative therapy
Conservative modalities
• • •
Surgical intervention
Left
Bunion
Hammertoe
Which one
• • •
MPJ Capsulotomy
Which One
• • •
Weight-bearing status
• • •
New Short Text Field.
Right
Bunion
Hammertoe
Which one
• • •
MPJ Capsulotomy
Which One
• • •
Flexor Tenotomy (Only one digit.) - 28010
Flexor Tenotomy (More than one digit.) - 28011
Removal Foreign Body-Subq - 28190
Removal$Foreign Body-Deep - 28192
I & D Abscess Simple - 10060
Weight-bearing status
• • •
Risks/Benefits/Post-op
Post-op Pain medication
• • •
New Short Text Field.
Lab Work/Imaging studies/Pathology
LFT
CBC
BMP
VIT D
Scanogram
Nail Pathology
EMG/NCV
Left
right
MRI
MRI
CT SCAN
CT SCAN
Bone Scan
Bone Scan
Soft tissue mass pathology
Soft tissue mass pathology
Cultures
Cultures
Follow up
Time
• • •

Assessment/Plan/Procedures performed Medical Form

Podiatrist

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Published: Jan. 11, 2022, 1:01 p.m.
Doctor: Dr. History Physical
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