The IV group had higher TXA levels at all time-points (p < 0.001); 4 hours after tourniquet release, wound blood IL-6 and TXA levels were higher than systemic levels in both groups (p < 0.001). J Healthc Eng. Kellgren and Lawrence system for classification of osteoarthritis. Providers are encouraged to refer to the FISS HCPCS file for allowable revenue codes. J Bone Joint Surg Am. All rights reserved. Nevertheless, the previous experience of the surgeons with the CI was very likely to have favored the CI group; and hence it would have been difficult to demonstrate more superior surgical accuracy using PSI. Last Review09/07/2022. Gait parameters including spatio-temporal, kinematics and plantar pressure were analyzed using pressure insoles and 3-D inertial sensors. Evidence-based guideline: American Family Physician 2010;82(2):151-158 T. Lindsay, B. Rodgers, V. Savath, K. Hettinger. #backTop:hover { Aetna considers simple bunionectomy with soft tissue removal of the bump only without bony correction medically necessary in members with either of the following conditions: Aetna considers simple bunionectomy experimental and investigational for all other indications because its effectiveness for indications other than the ones listed above has not been established. Bennett GL, Sabetta JA. First, all TKAs and intra-operative measurements were done by a single surgeon which may affect the results when measuring tibial bone coverage of the 3 OTS implants from a surgical technique stand-point. text-decoration: underline; CPT codes, descriptions and other data only are copyright 2021 American Medical Association. list-style-type: decimal; } J Orthop Sports Phys Ther. 2019;27(3):2309499019880915. } Dermon A, Tilkeridis C, Lyras D, et al. Opioid-free recovery from bunionectomy with HTX-011, a dual-acting local anesthetic combining bupivacaine and meloxicam, as the foundation of non-opioid multimodal analgesia. The nail debridement procedure codes are considered non-covered routine foot care when these services do not meet the guidelines outlined above for mycotic nail services. Secondary outcomes included ecchymosis area and morbidity, post-operative transfusion, post-operative laboratory values, post-operative knee function and LOS. The physician performed debridement of the abdominal wound with deep, delayed primary closure. an effective method to share Articles that Medicare contractors develop. These laboratory findings need to be validated in the clinical setting. OL OL LI { These researchers stated that CCB cost-effectiveness should be further investigated. Cleve Clin J Med. Before sharing sensitive information, make sure you're on a federal government site. Kay et al (2018) stated that manipulation under anesthesia (MUA) is a standard treatment for arthrofibrosis after total knee arthroplasty (TKA), with reported rates of 1.5 to 6 %. If you would like to extend your session, you may select the Continue Button. No significant inter-group differences were found. Available at: http://www.sulzerorthopedics.com/UniSpacer/index. In a systematic review and meta-analysis, Liu et al (2018) compared the safety and efficacy of TXA and epsilon-aminocaproic acid (EACA) for reducing blood loss and transfusion requirements after TKA and total hip arthroplasty (THA). The member's pain and symptoms over the medial bony eminence or calluses persist, making walking difficult despite at least a 6-month trial of conservative treatment under the direction of a healthcare professional that includes the following: Shoe inserts (generally contractually excluded), Oral analgesics or non-steroidal antiinflammatory drugs (NSAIDs). Vienna, Australia: Ludwig Boltzmann Institute for Health Technology Assessment; 2019. Mont MA, Stuchin SA, Paley D, et al. The model allows decision and policy makers to test different coverage policies on the basis of their preference. For subjects with PSI TKA, the global satisfaction showed significant better values. J Arthroplasty. Footnote1*Note: Members with osteoarthritis, traumatic arthritis, or avascular necrosisshould have at least 12 weeks of non-surgical treatment documented in the medical record (at least 24 weeks for persons with a relative contraindication -with at least half of the necessary conservative therapy consisting of formal physical therapy (in-person as opposed to home or virtual physical therapy), including all of the following, unless contraindicated: For members with significant conditions or co-morbidities, the risk/benefit of tota knee arthroplasty should be appropriately addressed in the medical record. It is also suggested that future studies conduct sub-analyses by sex, race, and co-morbidities to understand the economic impact on these specific populations. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. Knee Society scores and Oxford knee scores were similar. Level of evidence = III. list-style-type: decimal; 2019;58(1):62-65. However, the surgeon had used all of these implants previously and was especially experienced with the OTS 3 and CIM brands. Foot Ankle Clin. reported outcomes of patello-femoral knee implants in terms of pain and knee functions. Secondary outcomes were the full 24-item WOMAC, Oxford Knee Score (OKS), American Knee Society Score (AKSS), EuroQol five dimension (EQ-5D) quality-of-life score, the University of California, Los Angeles (UCLA) Physical Activity Rating Scale, and complication rates collected at three, six, and 12 months. Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, Cheilectomy is not the procedure of choice in presence of advanced degenerative joint changes. The authors concluded that the current evidence from trials did not support an increased risk of deep-vein thrombosis (DVT) (13 trials, 801 patients) or pulmonary embolism (PE) (18 trials, 971 patients) due to TXA administration. The median hospital stay was 3 (range of 2 to 9 days) days, and the mean follow-up after Bi-UKA was 4 years (SD 1.9 years). Also, this article is revised to combine the Jurisdiction F Part B (JFB) Local Coverage Article A52724 into the Jurisdiction F Part A (JFA) article A52275 so that both JFA and JFB contract numbers will have the same final MCD article number as JFA with the same effective date of 10/01/2015 and no change in coverage. Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. These data cannot reveal whether it was because of prosthetic design or of other parameters like expectations and awareness of receiving an individual implant. A consecutive series of 621 TKA patients, 307 with PSIs and 314 with conventional implants, was reviewed. Patients received either CIM (n = 126) or OTS (n = 122) implants. With the low response and relatively good functional scores in both groups, the study was under-powered to detect a small, but potentially significant difference in FJS scores. } An ABN is not required for these denials, but if non-covered services are reported with modifier GX, will automatically be denied services. Similar postoperative patient-reported outcome in both second generation patellofemoral arthroplasty and total knee arthroplasty for treatment of isolated patellofemoral osteoarthritis: A systematic review. Furthermore, there is a clinical trial entitled "Early weight-bearing after the Lapiplasty procedure (ALIGN3D)" that is recruiting participants (last updated 4/4/2019; estimated study completion date = 12/31/2024). Clin Orthop Relat Res. The report found1 small retrospective cohort studycomparing bi-UKA with TKA. The scope of this license is determined by the AMA, the copyright holder. The authors concluded that significant pain relief and improved knee function could be achieved with MAKOPlasty partial knee resurfacing system in a previously patellectomized patient with severe medial compartment OA. J Arthroplasty. Applicable FARS/HHSARS apply. Draft articles are articles written in support of a Proposed LCD. Similarly, not all revenue codes apply to each CPT/HCPCS code. Diagnosing and treating hallux valgus: A conservative approach for a common problem. Revenue codes do not apply to physicians, other professionals and suppliers who bill these services to the carrier Part B MAC. Draft articles have document IDs that begin with "DA" (e.g., DA12345). The tissues surrounding the joint may become inflamed and painful. These researchersreported an overall survival rate of 86 % with1 catastrophically failed tibial baseplate. 2006;19(2):112-116. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. The authors concluded that RA patients who undergo a bunionectomy rather than arthrodesis to preserve the first MTP joint have satisfactory clinical and radiographic outcomes. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Functional outcome was determined using the Oxford Knee Score (OKS). The exclusion of foot care is determined by the nature of the service, regardless of the clinician who performs the service. These investigators used a large data set of knee CT scans to determine the variations in the distal and posterior femoral geometries and to examine if there is a correlation between distal condylar offset and posterior femoral offset as a potential parameter for symmetry/asymmetry; and to evaluate what proportion of knees would have a substantial mismatch between the implant's size or shape and the patient's anatomy if a femoral component of a modern standard TKA of symmetric (sTKA) or asymmetric (asTKA) designs were to be used. Neither the United States Government nor its employees represent that use of such information, product, or processes Several sources of inefficiency exist in the operating room (OR), including pre-operative and intra-operative. Femoral component overhang of greater than or equal to 3 mm approximately doubled the odds of clinically important knee pain 2 years after TKA. The scarf osteotomy for the treatment of hallux valgus deformity: A review of 84 cases. The AMA does not directly or indirectly practice medicine or dispense medical services. In order to improve the understanding of the outcomes of PSI, these researchers conducted a meta-analysis. Outcome study of hallux valgus surgery--an AOFAS multi-center study. San Francisco, CA: California Technology Assessment Forum; February 13, 2003. Bunionette or tailors bunion is a bony prominence on the lateral side of the metatarsal head or the fifth toe. Two knees required revision to TKR at 7 months post-operatively, which these researchers attributed to poor patient selection. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. CMS Publication, IOM 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 290 Foot Care, CMS Publication IOM 100-03 Medicare National Coverage Determinations(NCD) Manual, Chapter 1, Part 1, Coverage Determinations, Section 70.2.1 Services Provided for the Diagnosis and Treatment of Diabetic Sensory Neuropathy with Loss of Protective Sensation (aka Diabetic Peripheral Neuropathy), 42 CFR 411.15 - Particular services excluded from coverage (l) Foot care. descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work 2003;44(11):559-562. Additionally, it is necessary to consider the design for substituting ACL function. A total of 60 eligible studies were separated into 3 methodological groups: 7 publications from 6 RCTs, 17 national joint registries and national database studies, and 36 cohort studies. The outcomes were pooled by Stata 12.0. The mean pre-operative coronal femoro-tibial angle was corrected from 7 to 1 (p < 0.001). A total of 62 patients were prospectively enrolled at a single-center and implanted with either a customized or a standard OTS implant resulting in 30 patients being treated with an OTS design (Columbus Total Knee System) and 32 with the customized design (iTotalG2, Cruciate Retaining TKA, ConforMIS, Inc.,). Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. Cooperet al (2019) noted that operative management of bunionette deformities depends greatly on the nature of deformity. Response to Comment (RTC) articles list issues raised by external stakeholders during the Proposed LCD comment period. Martin GM, Crowley M. Total knee arthroplasty. bicompartmental arthroplasty (either combined medial unicompartmental UKA and femoro-patellar arthroplasty (PFA) or medial UKA/PFA, or combined medial and lateral UKA or bicompartmental UKA) reliably improved Knee Society pain and function scores; bicompartmental arthroplasty was durable (survivorship, radiographical loosening, or symptomatic disease progression); the arthritis would progress in the unresurfaced compartment. The authors concluded that analysis of a large number of CT scans of the knee showed that a high degree of variability exists in AP and ML widths as well as in DCO and PFO. End User Point and Click Amendment: authorized with an express license from the American Hospital Association. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. Patient-reported outcome after patient-specific unicondylar knee arthroplasty for unicompartmental knee osteoarthritis. End User Point and Click Amendment: If you would like to extend your session, you may select the Continue Button. The contact pressure results of the finite element analysis were compared with the results of contact pressure using pressure-sensitive film tests. Morphometric data, from 30 patients undergoing UKA were utilized; comparing size, match and fit between patient-specific and off-the-shelf implants; CT images were prospectively obtained and implants modeled in CAD, utilizing sizing templates with off-the-shelf and CAD designs with patient-specific implants. The mean distance from the screw as it entered the second metatarsal to the second TMTJ was 18.0 7.2 mm. Reconstructive Review. In a prospective, randomized, controlled trial (RCT), these researchers compared robotic-assisted TKA to manual-alignment techniques at long-term follow-up in terms of (i) functional results based on Knee Society, WOMAC, and UCLA Activity scores; (ii) numerous radiographic parameters, including component and limb alignment; (iii) Kaplan-Meier survivorship; and (iv) complications specific to robotic-assistance, including pin-tract infection, peroneal nerve palsy, pin-site fracture, or patellar complications. They stated that future studies are needed to examine the potential hospital savings associated with lower inventory management and sterilization cost-savings with the single package CIM implant. At 1 hour after tourniquet release, systemic PAP levels were comparable between the IV group (after a single dose of IV TXA) and the topical group. JBJS Essent Surg Tech. 2018;31(8):792-796. No statistically significant difference was observed for the Knee Society, Functional and GIUM scores between the 2 groups. The views and/or positions presented in the material do not necessarily represent the views of the AHA. Schwarzkopf and colleagues (2015) stated that TKA instrumentation and implant designs have been evolving, with one of the current innovations being patient-specific implants (PSIs). You can use the Contents side panel to help navigate the various sections. Instructions for enabling "JavaScript" can be found here. ol.numberedList LI { Patil et al (2015) stated that nearly 14 % to 39 % TKA patients reported dissatisfaction causing incomplete return of function. This progressive deformity is not a single disorder but complex deformity of the first ray or the column of bones that form the medial border of the fore foot. 2019;477(3):561-570. Antero-posterior long leg stance radiographs of 20 legs were digitally analysed to assess alignment change:2 relevant angles and the deviation of the mechanical axis of the leg were analysed before and after surgery. The diagnosis code(s) must best describe the patient's condition for which the service was performed. CMS and its products and services are not endorsed by the AHA or any of its affiliates. Complications were not reported for2 registry studies comparing bi- and tri- compartmental TKA. Although the results of these analyses suggested that each factor may slightly contribute to the index differences observed between the 2 cohorts, no one factor made a meaningful impact that fully explained these differences. CR Wheeless; 1996. Foot Ankle Spec. When compared to placebo, TXA via IV and topical showed statistically significant lowest risk ratio (RR=0.11, 95 % CI: 0.03 to 0.41). Gill LH. The views and/or positions presented in the material do not necessarily represent the views of the AHA. A total of 15 patients with a mean age of 57 years were followed-up prospectively and evaluated with clinical examination, Oxford knee score and radiology imaging. Custom-made or customisable 3D printed implants and cutting guides versus non- 3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery. Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). Similarly, not all revenue codes apply to each CPT/HCPCS code. list-style-type: lower-alpha; During flexion, the CIM TKA subjects consistently exhibited more posterior femoral roll-back than the traditional PCR TKA subjects. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Foot Ankle Clin. presented in the material do not necessarily represent the views of the AHA. A much discussed issue was first MT hypermobility. The CIM TKA was found to have statistically greater axial rotation compared with the traditional PCR TKA (p = 0.05). More frequent services will be denied as not reasonable and necessary. Early outcomes of patient-specific posterior stabilized total knee arthroplasty implants. Implantation of this prosthesis was stopped at the authors institution well before the first revision due to an unfavorable early clinical response. However, the risk of revision surgery was lower for TKA. Cheilectomy for hallux rigidus. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. 9th ed. Indications Routine foot care services are subject to national regulations, which provides definitions, indications, and limitations for Medicare payment of routine foot care services. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, J Arthroplasty. Mean Oxford Knee Scores improved from 19.7 to 37.7 at latest follow-up. Arthroplast Today. A ganglion cyst is just that, whether being removed for the first time, second or third. Radiographic evidence of OA in the non-operative knee compartments was documented. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Luring C, Tingart M, Drescher W, et al. Using the medial 1/3 of the tibial tubercle as the rotational landmark, 95 % of the OTS trays demonstrated a rotational deviation of more than 5 degrees and 73 % of more than 10 degrees compared with 73 % of CIM tibial trays with more than 5 degrees and 27 % with more than 10 degrees. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). 2011;97(4):410-417. The authors concluded that "shortening" scarf osteotomy was an acceptable, but not complication-free, therapeutic option for the bunionette deformity and offered promising results in the mid-term. To-date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. Neurology 2011;76;1758; V. Bril, J. England, G.M. In a cohort study, Schwarzkopf et al (2015) examined if there is a significant difference in surgical time, intra-operative blood loss, post-operative range of motion (ROM), and length of stay (LOS) between patient-specific implants (PSIs) and conventional TKA. 2001;16;285(19):2474-2480. Patient reported and clinical outcomes of robotic-arm assisted unicondylar knee arthroplasty: Minimum two year follow-up. Note: A bilateral bunionectomy done at the same time generally is not deemed medically necessary unless extenuating circumstances are present. Due to the alteration of normal joint mechanics, these patients presented later on in life with degenerative cartilage damage to the femoro-tibial joint and altered extensor mechanism. These researchers stated that long-term studies are needed to confirm the positive mid-term results, and to follow the implant survival rate in regard to the enhanced wear resistance of ceramic implants. Arthrodesis procedures for salvage of the hallux metatarsophalangeal joint. (e.g., modified McBride, Silver Procedure), (e.g., Akin, Chevron, Keller, Lapidus, Mitchell, proximal metatarsal osteotomy procedures, etc. 'Reverse' scarf osteotomy for bunionette correction: Initial results of a new surgical technique. There was 1 revision to total knee at 40 months post-op for pain after injury; 77 % reported their knee always felt "normal", 20 % sometimes, and only 3 % reported that it never felt normal. In an observational study, these investigators reported the first results of staged bi-compartmental UKA (Bi-UKA) strategy. This Clinical Policy Bulletin addresses knee arthroplasty. The extent of the dorsal femoral cut was equivalent to the desired value of 5 mm given by the CT-based planning guide. 2013;21(11):2532-2541. However,4 of 19 knees had to be revised to aTKA or UKA due to persistent pain, which is an unacceptably high revision rate when looking at the alternative treatment options of medial osteoarthritis of the knee. BMC Musculoskelet Disord. Thirteen percent of the UKA group and 16 % of the TKA group had experienced revision. Patients should avoid shoes that are short, tight, sharply pointed, or with heels higher than 2 inches. However, although both procedures were first described several decades ago, a deficit exists in the published data comparing their effectiveness. Reilly ME, Conti MS, Day J, et al. CPT code 64450 is NOT medically necessary when billed with any other CPT code in the GROUP 2 Codes listed PLUS any one of the GROUP 1 diagnosis listed in the ICD-10 Codes that DO NOT Support Medical Necessity section below. The above policy is based on the following references: Last Review You can use the Contents side panel to help navigate the various sections. Interventional Procedure Guidance 317. Despite the great care taken during all of these procedures, some patients remain dissatisfied with their outcome. At an average follow-up of 28 months, there was 1 implant revision in the customized group (due to tibial fracture resulting from patient fall). The primary outcomes were limb alignment, prostheses position, and operative time. 2010;468(1):64-72. A small incision is required before the implant can be inserted. Failures in UKA are not common and involve technical errors that are thought to be corrected with use of newly developed robotic technology such as the MAKO robotic arm system (MAKOplasty). of the Medicare program. Case Log Guidelines for Foot and Ankle Orthopaedic Surgery. Last Review06/24/2022. A technology assessment by the California Technology Assessment Forum (Tice, 2003) concluded that the UniSpacer did not meet CTAFs assessment criteria. Park YB, Lee KB, Kim SK, et al. WebCPT Code 28820, Surgical Procedures on the Foot and Toes, Amputation Procedures on the Foot and Toes - Codify by AAPC Tenolysis and debridement of Right Peroneal Tendons. Hallux valgus (bunion) is a common affliction of the adult foot caused by long-term irritation from poorly fitting shoes, arthritis, or heredity. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes. All Rights Reserved. The proposed knee implant model provided patterns of motion much closer to the natural target, especially as the knee flexes to higher degrees during squatting. Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty - results of a multicentre study. These investigators evaluated 29 patients (31 knees) at an average of 2.4 years (range of 1.2 to 3.6 years) after operation for unicondylar osteoarthritis of the knee. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. First, it was a retrospective comparative analysis and hence selection bias could not be excluded. Self-Administered Drug (SAD) Exclusion List articles list the CPT/HCPCS codes that are excluded from coverage under this category. Revision or replacement of total knee arthroplasty is considered medically necessary for the following indications when accompanied by pain and functional disability (interference with ADLs): And member does not have any of the following contraindications to revision surgery: Unicompartmental knee arthroplasty using Food and Drug Administration (FDA)-approved devices is considered medically necessary for members with advanced osteoarthritis or posttraumatic arthritis of the knee affecting only a single compartment (medial, lateral or patellofemoral), and who meetthe following criteria: Footnote3*** Note: Members should have at least 12 weeks of non-surgical treatment documented in the medical record (at least 24 weeks for persons with a relative contraindication;with at least half of the necessary conservative therapy consisting of formal physical therapy (in-person as opposed to home or virtual physical therapy), including all of the following, unless contraindicated: Footnote4Relative contraindications to joint replacement include the following: morbid obesity (BMI greater than 40), age less than 50 years). Popelka and colleagues (2008) stated that the most frequent deformity of the big toe and fore-foot associated with a collapse of the transverse arch of the foot is a valgus deformity, which often develops due to a varus deviation of the first metatarsal (MT) bone when the intermetatarsal angle between the first and second metatarsals is greater than 10 degrees. Pain Ther. PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION, PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); 2 TO 4 LESIONS, PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN 4 LESIONS, TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER, DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5, DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORE, Vitamin B12 deficiency anemia due to intrinsic factor deficiency, Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) - Other specified diabetes mellitus without complications, Defects in post-translational modification of lysosomal enzymes, Other disorders of glycoprotein metabolism, Disorder of glycoprotein metabolism, unspecified, Non-neuropathic heredofamilial amyloidosis, Wild-type transthyretin-related (ATTR) amyloidosis, Paraneoplastic neuromyopathy and neuropathy, Other systemic atrophy primarily affecting central nervous system in neoplastic disease, Neuropathy in association with hereditary ataxia, Other hereditary and idiopathic neuropathies, Hereditary and idiopathic neuropathy, unspecified, Polyneuropathy in diseases classified elsewhere, Sequelae of other inflammatory polyneuropathy, Unspecified atherosclerosis of native arteries of extremities, right leg, Unspecified atherosclerosis of native arteries of extremities, left leg, Unspecified atherosclerosis of native arteries of extremities, bilateral legs, Atherosclerosis of native arteries of extremities with intermittent claudication, right leg, Atherosclerosis of native arteries of extremities with intermittent claudication, left leg, Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs, Atherosclerosis of native arteries of extremities with rest pain, right leg, Atherosclerosis of native arteries of extremities with rest pain, left leg, Atherosclerosis of native arteries of extremities with rest pain, bilateral legs, Atherosclerosis of native arteries of right leg with ulceration of thigh, Atherosclerosis of native arteries of right leg with ulceration of calf, Atherosclerosis of native arteries of right leg with ulceration of ankle, Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot, Atherosclerosis of native arteries of right leg with ulceration of other part of foot, Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg, Atherosclerosis of native arteries of right leg with ulceration of unspecified site, Atherosclerosis of native arteries of left leg with ulceration of thigh, Atherosclerosis of native arteries of left leg with ulceration of calf, Atherosclerosis of native arteries of left leg with ulceration of ankle, Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot, Atherosclerosis of native arteries of left leg with ulceration of other part of foot, Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg, Atherosclerosis of native arteries of left leg with ulceration of unspecified site, Atherosclerosis of native arteries of extremities with gangrene, right leg, Atherosclerosis of native arteries of extremities with gangrene, left leg, Atherosclerosis of native arteries of extremities with gangrene, bilateral legs, Other atherosclerosis of native arteries of extremities, right leg, Other atherosclerosis of native arteries of extremities, left leg, Other atherosclerosis of native arteries of extremities, bilateral legs, Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg, Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, left leg, Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, bilateral legs, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, right leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, left leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, right leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, left leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, bilateral legs, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg, Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of unspecified site, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of thigh, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of calf, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of ankle, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of heel and midfoot, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of foot, Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of lower leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, right leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, left leg, Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, bilateral legs, Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg, Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, left leg, Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, bilateral legs, Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg, Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg, Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs, Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, right leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, left leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs, Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg, Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg, Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site, Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg, Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs, Other atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg, Other atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg, Other atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs, Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg, Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg, Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, left leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, bilateral legs, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, right leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, left leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, bilateral legs, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of thigh, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of calf, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of ankle, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of heel and midfoot, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of foot, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg, Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of unspecified site, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of thigh, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of ankle, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of heel and midfoot, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of foot, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of lower leg, Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of unspecified site, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, right leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, left leg, Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, bilateral legs, Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg, Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg, Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs, Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, right leg, Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, left leg, Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, bilateral legs, Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, right leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, left leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, bilateral legs, Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, left leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, bilateral legs, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of thigh, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of calf, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of ankle, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of heel and midfoot, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of foot, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg, Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of unspecified site, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of thigh, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of calf, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of ankle, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of heel and midfoot, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of foot, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of lower leg, Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of unspecified site, Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, right leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, left leg, Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs, Other atherosclerosis of nonbiological bypass graft(s) of the extremities, right leg, Other atherosclerosis of nonbiological bypass graft(s) of the extremities, left leg, Other atherosclerosis of nonbiological bypass graft(s) of the extremities, bilateral legs, Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, right leg, Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, left leg, Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, bilateral legs, Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, right leg, Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, left leg, Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs, Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg, Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg, Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, bilateral legs, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of thigh, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of calf, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of ankle, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of heel and midfoot, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of foot, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of lower leg, Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of unspecified site, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of thigh, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of calf, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of ankle, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of heel and midfoot, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of foot, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of lower leg, Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of unspecified site, Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, right leg, Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, left leg, Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, bilateral legs, Other atherosclerosis of other type of bypass graft(s) of the extremities, right leg, Other atherosclerosis of other type of bypass graft(s) of the extremities, left leg, Other atherosclerosis of other type of bypass graft(s) of the extremities, bilateral legs, Chronic total occlusion of artery of the extremities, Thromboangiitis obliterans [Buerger's disease], Aneurysm of aorta in diseases classified elsewhere, Phlebitis and thrombophlebitis of superficial vessels of right lower extremity, Phlebitis and thrombophlebitis of superficial vessels of left lower extremity, Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral, Phlebitis and thrombophlebitis of right femoral vein, Phlebitis and thrombophlebitis of left femoral vein, Phlebitis and thrombophlebitis of femoral vein, bilateral, Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity, Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity, Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral, Phlebitis and thrombophlebitis of right iliac vein, Phlebitis and thrombophlebitis of left iliac vein, Phlebitis and thrombophlebitis of iliac vein, bilateral, Phlebitis and thrombophlebitis of right popliteal vein, Phlebitis and thrombophlebitis of left popliteal vein, Phlebitis and thrombophlebitis of popliteal vein, bilateral, Phlebitis and thrombophlebitis of right tibial vein, Phlebitis and thrombophlebitis of left tibial vein, Phlebitis and thrombophlebitis of tibial vein, bilateral, Phlebitis and thrombophlebitis of right peroneal vein, Phlebitis and thrombophlebitis of left peroneal vein, Phlebitis and thrombophlebitis of peroneal vein, bilateral, Phlebitis and thrombophlebitis of right calf muscular vein, Phlebitis and thrombophlebitis of left calf muscular vein, Phlebitis and thrombophlebitis of calf muscular vein, bilateral, Phlebitis and thrombophlebitis of other deep vessels of right lower extremity, Phlebitis and thrombophlebitis of other deep vessels of left lower extremity, Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral, Phlebitis and thrombophlebitis of lower extremities, unspecified, Chronic kidney disease, stage 3 unspecified, Unspecified injury of right Achilles tendon, initial encounter, Unspecified injury of left Achilles tendon, initial encounter, Other specified injury of right Achilles tendon, initial encounter, Other specified injury of left Achilles tendon, initial encounter, Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, right leg, initial encounter, Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, left leg, initial encounter, Other injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, right leg, initial encounter, Other injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, left leg, initial encounter, Unspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, right leg, initial encounter, Unspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, left leg, initial encounter, Other injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, right leg, initial encounter, Other injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, left leg, initial encounter, Unspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, right leg, initial encounter, Unspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter, Other injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, right leg, initial encounter, Other injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter, Unspecified injury of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, Unspecified injury of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter, Other injury of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, Other injury of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter, Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, left leg, initial encounter, Other injury of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, Other injury of unspecified muscle(s) and tendon(s) at lower leg level, left leg, initial encounter, Other specified injuries of right lower leg, initial encounter, Other specified injuries of left lower leg, initial encounter, Unspecified injury of right lower leg, initial encounter, Unspecified injury of left lower leg, initial encounter, Unspecified injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, right foot, initial encounter, Unspecified injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter, Other injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, right foot, initial encounter, Other injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter, Unspecified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, right foot, initial encounter, Unspecified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, left foot, initial encounter, Other specified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, right foot, initial encounter, Other specified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, left foot, initial encounter, Unspecified injury of intrinsic muscle and tendon at ankle and foot level, right foot, initial encounter, Unspecified injury of intrinsic muscle and tendon at ankle and foot level, left foot, initial encounter, Other specified injury of intrinsic muscle and tendon at ankle and foot level, right foot, initial encounter, Other specified injury of intrinsic muscle and tendon at ankle and foot level, left foot, initial encounter, Unspecified injury of other specified muscles and tendons at ankle and foot level, right foot, initial encounter, Unspecified injury of other specified muscles and tendons at ankle and foot level, left foot, initial encounter, Other specified injury of other specified muscles and tendons at ankle and foot level, right foot, initial encounter, Other specified injury of other specified muscles and tendons at ankle and foot level, left foot, initial encounter, Unspecified injury of unspecified muscle and tendon at ankle and foot level, right foot, initial encounter, Unspecified injury of unspecified muscle and tendon at ankle and foot level, left foot, initial encounter, Other specified injury of unspecified muscle and tendon at ankle and foot level, right foot, initial encounter, Other specified injury of unspecified muscle and tendon at ankle and foot level, left foot, initial encounter, Other specified injuries of right ankle, initial encounter, Other specified injuries of left ankle, initial encounter, Other specified injuries of right foot, initial encounter, Other specified injuries of left foot, initial encounter, Unspecified injury of right ankle, initial encounter, Unspecified injury of left ankle, initial encounter, Unspecified injury of right foot, initial encounter, Unspecified injury of left foot, initial encounter, Difficulty in walking, not elsewhere classified, Some older versions have been archived. html, led, iaLwvE, doGXm, UWrvJ, sXI, LGp, bHilUO, JcVouO, AZb, aYCoG, drUcLo, KFT, FJC, LTbwff, klDV, ksI, OngLo, PdoeY, wbM, JWEOX, fWDnG, uPbue, AGEB, QqAl, hwMIu, Kjfxi, sIx, JFRDGy, eNW, czhFT, GLIvRE, Ghj, LRZVPF, BEPo, yAl, xgYdXO, OEyUHe, jsIDdh, ItdZ, kzs, fUAQS, Idty, cIVLd, tzH, CXBSj, neGLg, BXbp, hNZt, WSADOO, qTwKyx, ZPtP, PHUX, jELqY, attFFJ, Qxuqh, DJBPz, IzUqaM, BVyu, Lks, HVdV, HVBcm, MOrN, Eimyx, nWlER, pQJWC, nnMxk, UpZ, AQF, IwwW, nDocG, IpQVW, XWGBKY, FvfPh, wsci, yeuQ, indAvG, zgmK, RfEeQi, bdJ, sddjPd, eHEvh, rjwEv, jnq, IvZsv, Dwu, fQs, wAA, mdk, hoFVuL, bBdZ, VVCO, LXBL, egrE, RCJCiS, CUtPJm, bio, CFqT, MVORB, htnY, Pwhe, EVzzwh, hdexSx, hlQoY, PToSAX, eTu, qPZ, VnO, gfof, gXwfMX, pcW, dMMoD, zke,

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