C.Ped flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Semmes-Weinstein 10-g monofilament

Tests protective sensation; inability to feel the 10-g force at tested plantar sites indicates loss of protective sensation and high ulcer risk.

Ankle-brachial index

Ratio of ankle to brachial systolic pressure; below 0.90 suggests peripheral arterial disease, while above 1.30 suggests non-compressible calcified vessels.

Subtalar joint neutral position

The position where the talus is congruently aligned with the navicular without medial or lateral bulging, used as the reference for forefoot measurements.

Resting calcaneal stance position

Angle of the posterior calcaneus relative to the lower leg during relaxed standing; normally 2 to 6 degrees everted, with greater eversion suggesting a pronated foot.

Forefoot varus deformity

The forefoot is inverted relative to the rearfoot when the subtalar joint is held in neutral, so the first metatarsal head sits higher than the fifth.

Three rockers of gait

Heel rocker at initial contact, ankle rocker during midstance, and forefoot rocker at push-off; loss of any rocker alters ground reaction force progression.

Wagner ulcer classification

Six-point scale from grade 0, intact skin with deformity, to grade 5, whole-foot gangrene; grades 1 to 3 describe ulcer depth and infection.

Lateral wedge insole

An insert made thicker on the lateral side to reduce the external knee adduction moment in medial compartment knee osteoarthritis by shifting load laterally.

Total contact cast

Gold-standard offloading for neuropathic plantar ulcers that distributes weight across the whole plantar surface; contraindicated with active infection or severe ischemia.

Rocker-bottom sole

A curved outsole that shifts the center of pressure and reduces peak plantar pressure at the metatarsal heads during walking when the forefoot is stiffened.

Extra-depth diabetic shoe

Footwear with about three-eighths of an inch of added interior depth to accommodate a custom insert and relieve pressure on prominent toes and metatarsal heads.

Solid ankle AFO

Rigid thermoplastic orthosis that blocks both ankle dorsiflexion and plantarflexion, providing mediolateral stability and clearing the toes during swing phase.

Heel lift for limb discrepancy

A lift placed inside or outside the shoe to level the pelvis; differences under two centimeters are usually managed with an internal lift inside the shoe.

Plantar fasciitis orthosis design

Medial arch support combined with a firm heel cup and cushioned top cover to reduce tensile strain on the plantar fascia during weight bearing.

Positive model cast modification

Adding plaster to fill the arch and grinding reliefs over bony prominences before vacuum forming, so the finished shell matches the corrected foot shape.

Polypropylene orthosis shell

Rigid thermoplastic typically 3 to 5 millimeters thick, vacuum formed over the modified model to give firm, durable control of the medial arch.

Plastazote top cover

Closed-cell polyethylene foam that softens with heat and conforms to the foot, used as a cushioning top cover in total-contact and diabetic orthoses.

Orthosis break-in schedule

Wear one to two hours the first day and add one to two hours daily, checking the skin for redness before each increase in wear time.

Brannock measuring device

Tool recording heel-to-toe length, arch length, and width; the foot is measured while weight bearing, ideally late in the day when it is largest.

Orthosis trimline placement

Edges are cut clear of the first metatarsal head and fifth metatarsal base while retaining enough coverage to control the rearfoot and arch.

Blanching test at dispensing

Pressing the skin after a trial of wear to find redness that persists more than a few minutes, indicating localized pressure requiring adjustment.

Two-week follow-up visit

Reassessment after dispensing to check skin integrity, comfort, fit, and function, and to correct problems before the patient adapts to a poor fit.

Medicare diabetic shoe benefit

Coverage of one pair of therapeutic shoes and up to three pairs of inserts per calendar year for eligible beneficiaries with diabetes and a physician order.

Interfoot temperature difference

A difference greater than two degrees Celsius between matching sites on the two feet suggests active Charcot inflammation and warrants immobilization and referral.

Pediatric orthosis reassessment interval

Children grow quickly, so devices are rechecked every three to six months and replaced once the orthosis no longer fits the foot or shoe.

Device replacement interval

Soft EVA and foam orthoses typically last one to two years, while rigid thermoplastic devices last three to five years depending on wear and activity.

Serial wound area measurement

Tracing or photographing the ulcer at each visit documents healing progress and supports continued medical necessity for the offloading device.

KX modifier

A claim modifier attesting that the documentation on file supports medical necessity and that the coverage criteria for the billed device are satisfied.

Advance Beneficiary Notice

Form issued before providing an item likely to be denied as not medically necessary, transferring financial responsibility to the patient who accepts it.

PDAC coding verification

The Pricing, Data Analysis and Coding contractor reviews manufacturer documentation and confirms the correct L-code before claims for a device are submitted.

Certified Pedorthist scope of practice

Practice limited to footwear and foot orthoses below the knee; fitting ankle-foot orthoses or higher devices requires separate orthotic and prosthetic credentialing.

HIPAA minimum necessary rule

Only the protected health information needed for a specific purpose may be accessed, shared, or disclosed, including when sending records to a referral source.