Diabetic Foot Exam Form

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

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

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

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Has The Patient Had Prior Foot Care Education?

Cpt code (2028f, g0245, g0246, g9226) Any change in the foot. Comprehensive (visual, sensory, pulse) diabe c foot exam. Does the patient need diabetic shoes/ inserts?

(Check All That Apply.) Ii.

Adapted from the national diabetes education program’s foot screening form.

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