From the Guidelines
A CAM walker boot is typically supported by ICD-10 diagnoses related to foot, ankle, and lower leg injuries or conditions that require immobilization and protected weight-bearing, such as S92 codes for foot fractures, S82 codes for lower leg fractures, and codes for diabetic foot ulcers (E11.621) as recommended by the International Working Group of the Diabetic Foot (IWGDF) guidelines 1.
Common Supporting Diagnoses
- S92 codes for foot fractures (such as S92.0 for calcaneal fractures, S92.1 for talar fractures, and S92.3 for metatarsal fractures)
- S82 codes for lower leg fractures (including S82.6 for lateral malleolus fractures)
- S93 codes for ankle sprains and dislocations (particularly S93.4 for severe ankle sprains)
- M25.57 for foot/ankle pain
- M86 codes for osteomyelitis
- M77.5 for Achilles tendinitis
- M72.2 for plantar fasciitis
- S86.0 for Achilles tendon rupture
- M19.07 for post-traumatic ankle arthritis
- E11.621 for diabetic foot ulcers
- M14.6 for Charcot arthropathy
Rationale for Use
CAM walker boots are prescribed because they provide stability, immobilization, and offloading of pressure while allowing some mobility, which promotes healing while preventing further injury to the affected area, as supported by the IWGDF guidelines that recommend the use of non-removable knee-high offloading devices, such as total contact casts (TCC) or non-removable knee-high walkers, for the treatment of neuropathic plantar forefoot or midfoot ulcers in persons with diabetes 1.
Importance of Accurate Diagnosis Coding
The specific diagnosis code should accurately reflect the patient's condition to ensure proper medical necessity documentation for insurance coverage, highlighting the need for careful consideration of the patient's individual factors and the selection of the most appropriate offloading device, as recommended by the IWGDF guidelines 1.
From the Research
ICD 10 Diagnoses for CAM Walker Boot
The following ICD 10 diagnoses may support the use of a CAM walker boot:
- Fractures of the foot and ankle, such as:
- Fracture of calcaneus [S92.0]
- Fracture of talus [S92.1]
- Fracture of cuboid [S92.2]
- Fracture of navicular [S92.3]
- Fracture of cuneus [S92.4]
- Sprains and strains of the foot and ankle, such as:
- Sprain of ankle [S93.4]
- Strain of muscle and tendon at ankle and foot level [S93.5]
- Other foot and ankle injuries, such as:
- Contusion of foot [S90.0]
- Contusion of ankle [S90.1] As stated in the study 2, CAM boots are prescribed for the management of foot and ankle injuries to reduce ankle range of motion and offload the foot and ankle whilst allowing continued ambulation during recovery. However, the study does not provide a comprehensive list of ICD 10 diagnoses that support the use of a CAM walker boot.
Limitations
The study 2 highlights the lack of clarity within the current literature surrounding the biomechanical understanding and effectiveness of CAM boots, and the need for further research to fully understand the effectiveness of CAM boots for rehabilitation.