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Foot Injuries - what is the difference between #5283 & #5284?

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Navy4life

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Okay so I was looking up the ratings for the foot and I found two I should eventually fall under for my foot:

Code 5283: A broken bone in the foot, whether it has not healed properly or at all, is rated on how badly it affects the functioning of the foot. If it is just a bit painful, but overall the foot functions okay, then it is rated 10%. Something more serious, possibly causing significant pain, is rated 20%. Something very serious that significantly affects the use of the foot, but the foot can still be used, is rated 30%.

Code 5284: All other foot conditions and injuries are rated based on their severity and on how much the foot can be used. A moderate condition is rated 10%, a moderately severe condition rated 20%, and a severe condition rated 30%. This coding is only used if none of the other codes can satisfactorily describe the symptoms of the condition. For example, if there is a bone condition in the foot, but it isn’t a break, then it most likely will still be rated under code 5283 as a broken bone since it still affects the same kind of things a broken bone would. Similarly if the condition is a disease, then it should be rated under the code for a similar disease. If it doesn’t fit into any of those other options, then it can be rated here under 5284.

So since my right foot has two breaks to the 5th metatarsal bone (image attached) and I had surgery to repair it (image attached) where I had screws and pins to the spiral fracture and bone graft to the transverse fracture, which code suits me the best?  This break to my right foot is a DIRECT result to my L ankle issues (already S/C).

 

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IMG_1447.JPG

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Navy4Life,

You have photogenic bones!

Makes me ponder my own feet.  I am 30% for pes cavus(claw foot) w/plantar fasciitis, bilateral.  I also have a stress fracture of the 4th metatarsal that showed up on recent x-rays, and looks to be chronic.  It causes me a lot of pain, setting off a whole train of events, as far as aggravating my feet, ankles, knees and back. 

What I'm pondering is this...is it secondary to my SCD feet contention or what?  I've been living with it for 5+ years, whereas the SCD issue developed while still on AD in the late '90s.

I agree with green, definitely the 5283. 

Andyman

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3 minutes ago, Andyman73 said:

Navy4Life,

You have photogenic bones!

Makes me ponder my own feet.  I am 30% for pes cavus(claw foot) w/plantar fasciitis, bilateral.  I also have a stress fracture of the 4th metatarsal that showed up on recent x-rays, and looks to be chronic.  It causes me a lot of pain, setting off a whole train of events, as far as aggravating my feet, ankles, knees and back. 

What I'm pondering is this...is it secondary to my SCD feet contention or what?  I've been living with it for 5+ years, whereas the SCD issue developed while still on AD in the late '90s.

I agree with green, definitely the 5283. 

Andyman

thanks Andyman on the compliment for my bones being photogenic LOL

I really can't believe I am only 10% S/C for my left ankle with all the crap I had documented in my SMR's.  Now I have the NOD and my recent FDC to hopefully get the dots connected and get me S/C for both the feet/ankles for once and for all!!!

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That is just plain wrong, to lowball you, and then to force you to go through great lengths to show them the error of their ways.  Hey what evidence, oh that evidence...well, we didn't want to look at it, so we just ignored it.

Hope you find out before months end.

Andyman

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