Transcription of Screening Tool www.cawc
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60-second diabetic Foot ScreenScreening Toolinlow Name: Clinician Signature:ID number: Date:Look 20 secondsScoreCare RecommendationsLeft FootRight Foot1. Skin0 = intact and healthy1 = dry with fungus or light callus2 = heavy callus build up3 = open ulceration or history of previous ulcer2. Nails0 = well-kept1 = unkempt and ragged2 = thick, damaged, or infected3. Deformity0 = no deformity2 = mild deformity4 = major deformity4. Footwear0 = appropriate1 = inappropriate2 = causing traumaTouch 10 secondsLeft FootRight FootCare Recommendations5. Temperature Cold0 = foot warm 1 = foot is cold6. Temperature Hot0 = foot is warm1 = foot is hot7. Range of Motion0 = full range to hallux1 = hallux limitus2 = hallux rigidus 3 = hallux amputationAssess 30 secondsLeft FootRight FootCare Recommendations8.
60-second Diabetic Foot Screen Screening Tool inlow’S www.cawc.net Patient Name: Clinician Signature: ID number: Date: Look – 20 seconds Score
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Screening for Diabetic Peripheral Neuropathy, NEUROPATHY, DIABETIC, D iabetic peripheral neuropathy, A Vascular Doppler in Diabetics with, ON THE DIABETIC FOOT on the Diabetic Foot, Management of diabetic foot ulcers, Guidelines for the Prevention and Management, Annual Wellness Exam, Diabetes Mellitus, Diabetes, Quality Measurement in Orthopaedics, ICD-10 Diagnosis Codes, ICD 10 DIAGNOSIS CODES