Diabetic Foot Exam Form

Diabetic Foot Exam Form - Has the patient had prior foot care education? Cpt code (2028f, g0245, g0246, g9226) Any change in the foot. (check all that apply.) ii. Comprehensive (visual, sensory, pulse) diabe c foot exam. Does the patient need diabetic shoes/ inserts? Adapted from the national diabetes education program’s foot screening form.

Adapted from the national diabetes education program’s foot screening form. (check all that apply.) ii. Any change in the foot. Does the patient need diabetic shoes/ inserts? Has the patient had prior foot care education? Comprehensive (visual, sensory, pulse) diabe c foot exam. Cpt code (2028f, g0245, g0246, g9226)

(check all that apply.) ii. Comprehensive (visual, sensory, pulse) diabe c foot exam. Does the patient need diabetic shoes/ inserts? Has the patient had prior foot care education? Adapted from the national diabetes education program’s foot screening form. Cpt code (2028f, g0245, g0246, g9226) Any change in the foot.

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Cpt Code (2028F, G0245, G0246, G9226)

Has the patient had prior foot care education? Does the patient need diabetic shoes/ inserts? (check all that apply.) ii. Any change in the foot.

Adapted From The National Diabetes Education Program’s Foot Screening Form.

Comprehensive (visual, sensory, pulse) diabe c foot exam.

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