Physical Evaluation Board Forum

5000 Osteomyelitis, acute, subacute, or chronic
5001 Bones and joints, tuberculosis of, active or inactive
5002 Arthritis rheumatoid (atrophic) as an active process
5003 Arthritis, degenerative (hypertrophic or osteoarthritis)
5004 Arthritis, gonorrheal.
5005 Arthritis, pneumococcic.
5006 Arthritis, typhoid.
5007 Arthritis, syphilitic.
5008 Arthritis, streptococcic.
5009 Arthritis, other types (specify)
5010 Arthritis, due to trauma, substantiated by X-ray findings
5011 Bones, caisson disease of
5012 Bones, new growths of, malignant
5013 Osteoporosis, with joint manifestations
5014 Osteomalacia
5015 Bones, new growths of, benign
5016 Osteitis deformans
5017 Gout
5018 Hydrarthrosis, intermittent.
5019 Bursitis.
5020 Synovitis.
5021 Myositis.
5022 Periostitis.
5023 Myositis ossificans
5024 Tenosynovitis
5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome)




5051 Shoulder replacement (prosthesis)
5052 Elbow replacement (prosthesis)
5053 Wrist replacement (prosthesis)
5054 Hip replacement (prosthesis)
5055 Knee replacement (prosthesis)
5056 Ankle replacement (prosthesis)
5104 Anatomical loss of one hand and loss of use of one foot
5105 Anatomical loss of one foot and loss of use of one hand
5106 Anatomical loss of both hands
5107 Anatomical loss of both feet
5108 Anatomical loss of one hand and one foot
5109 Loss of use of both hands
5110 Loss of use of both feet
5111 Loss of use of one hand and one foot




Arm, amputation of:

5120 Disarticulation
5121 Above insertion of deltoid
5122 Below insertion of deltoid

Forearm, amputation of:

5123 Above insertion of pronator teres
5124 Below insertion of pronator teres
5125 Hand, loss of use of


Multiple Finger Amputations

5126 Five digits of one hand, amputation

Four digits of one hand, amputation of:

5127 Thumb, index, long and ring
5128 Thumb, index, long and little
5129 Thumb, index, ring and little
5130 Thumb, long, ring and little
5131 Index, long, ring and little

Three digits of one hand, amputation of:

5132 Thumb, index and long
5133 Thumb, index and ring
5134 Thumb, index and little
5135 Thumb, long and ring
5136 Thumb, long and little
5137 Thumb, ring and little
5138 Index, long and ring
5139 Index, long and little
5140 Index, ring and little
5141 Long, ring and little

Two digits of one hand, amputation of:

5142 Thumb and index
5143 Thumb and long
5144 Thumb and ring
5145 Thumb and little
5146 Index and long
5147 Index and ring
5148 Index and little
5149 Long and ring
5150 Long and little
5151 Ring and little

Single Finger Amputations

5152 Thumb, amputation of
5153 Index finger, amputation of
5154 Long finger, amputation of
5155 Ring finger, amputation of
5156 Little finger, amputation of





Thigh, amputation of:

5160 Disarticulation, with loss of extrinsic pelvic girdle muscles
5161 Upper third, one-third of the distance from perineum to knee joint
measured from perineum
5162 Middle or lower thirds




Leg, amputation of:

5163 With defective stump, thigh, amputation recommended
5164 Amputation not improvable by prosthesis controlled by
natural knee action
5165 At a lower level, permitting prosthesis
5166 Forefoot, amputation proximal to metatarsal bones (more than
one-half of metatarsal loss)
5167 Foot, loss of use of
5170 Toes, all, amputation of, without metatarsal loss
5171 Toe, great, amputation of
5172 Toes, other than great, amputation of, with removal of metatarsal head
5173 Toes, three or four, amputation of, without metatarsal involvement




5200 Scapulohumeral articulation, ankylosis of
5201 Arm, limitation of motion of
5202 Humerus, other impairment of
5203 Clavicle or scapula, impairment of



5205 Elbow, ankylosis of
5206 Forearm, limitation of flexion of
5207 Forearm, limitation of extension of
5208 Forearm, flexion limited to 100° and extension to 45°
5209 Elbow, other impairment of Flail joint
5210 Radius and ulna, nonunion of, with flail false joint
5211 Ulna, impairment of
5212 Radius, impairment of
5212 Radius, impairment of
5213 Supination and pronation, impairment of




5214 Wrist, ankylosis of
5215 Wrist, limitation of motion of






I. Multiple Digits: Unfavorable Ankylosis

5216 Five digits of one hand, unfavorable ankylosis of
5217 Four digits of one hand, unfavorable ankylosis of
5218 Three digits of one hand, unfavorable ankylosis of
5219 Two digits of one hand, unfavorable ankylosis of
5220 Five digits of one hand, favorable ankylosis of
5221 Four digits of one hand, favorable ankylosis of
5222 Three digits of one hand, favorable ankylosis of
5223 Two digits of one hand, favorable ankylosis of
5224 Thumb, ankylosis of
5225 Index finger, ankylosis of
5226 Long finger, ankylosis of
5227 Ring or little finger, ankylosis of
5228 Thumb, limitation of motion
5229 Index or long finger, limitation of motion
5230 Ring or little finger, limitation of motion





5235 Vertebral fracture or dislocation
5236 Sacroiliac injury and weakness
5237 Lumbosacral or cervical strain
5238 Spinal stenosis
5239 Spondylolisthesis or segmental instability
5240 Ankylosing spondylitis
5241 Spinal fusion
5242 Degenerative arthritis of the spine (see also diagnostic code 5003)
5243 Intervertebral disc syndrome




5250 Hip, ankylosis of
5251 Thigh, limitation of extension of
5252 Thigh, limitation of flexion of
5253 Thigh, impairment of
5254 Hip, flail joint
5255 Femur, impairment of


5256 Knee, ankylosis of
5257 Knee, other impairment of
5258 Cartilage, semilunar, dislocated, with frequent episodes of
“locking,” pain, and effusion into the joint
5259 Cartilage, semilunar, removal of, symptomatic
5260 Leg, limitation of flexion of
5261 Leg, limitation of extension of
5262 Tibia and fibula, impairment of:
Nonunion of, with loose motion, requiring brace
5263 Genu recurvatum (acquired, traumatic, with weakness and
insecurity in weight-bearing objectively demonstrated)



5270 Ankle, ankylosis of
5271 Ankle, limited motion of
5272 Subastragalar or tarsal joint, ankylosis of
5273 Os calcis or astragalus, malunion of
5274 Astragalectomy




5275 Bones, of the lower extremity, shortening of



5276 Flatfoot, acquired
5277 Weak Foot, bilateral
5278 Claw foot (pes cavus), acquired
5279 Metatarsalgia, anterior (Morton’s disease), unilateral, or bilateral
5280 Hallux valgus, unilateral
5281 Hallux rigidus, unilateral, severe
5282 Hammer toe
5283 Tarsal, or metatarsal bones, malunion of, or nonunion of
5284 Foot injuries, other




5296 Skull, loss of part of, both inner and outer tables
5297 Ribs, removal of
5298 Coccyx, removal of


5301 Group I. Function: Upward rotation of scapula; elevation of arm above shoulder level. Extrinsic muscles of shoulder girdle: (1) Trapezius; (2) levator scapulae; (3) serratus magnus.
5302 Group II. Function: Depression of arm from vertical overhead to hanging at side (1, 2); downward rotation of scapula (3, 4); 1 and 2 act with Group III in forward and backward swing of arm. Extrinsic muscles of shoulder girdle: (1) Pectoralis major II (costosternal); (2) latissimus dorsi and teres major (teres major, although technically an intrinsic muscle, is included with latissimus dorsi); (3) pectoralis minor; (4) rhomboid.
5303 Group III. Function: Elevation and abduction of arm to level of shoulder; act with 1 and 2 of Group II in forward and backward swing of arm. Intrinsic muscles of shoulder girdle: (1) Pectoralis major I (clavicular); (2) deltoid.
5304 Group IV. Function: Stabilization of shoulder against injury in strong movements, holding head of humerus in socket; abduction; outward rotation and inward rotation of arm. Intrinsic muscles of shoulder girdle: (1) Supraspinatus; (2) infraspinatus and teres minor; (3) subscapularis; (4) coracobrachialis.
5305 Group V. Function: Elbow supination (1)long head of biceps is stabilizer of shoulder joint); flexion of elbow (1, 2, 3). Flexor muscles of elbow: (1) Biceps; (2) brachialis; (3) brachioradialis.
5306 Group VI. Function: Extension of elbow (long head of triceps is stabilizer of shoulder joint). Extensor muscles of the elbow: (1) Triceps; (2) anconeus.
5307 Group VII. Function: Flexion of wrist and fingers. Muscles arising from internal condyle of humerus: Flexors of the carpus and long flexors of fingers and thumb; pronator.

5308 Group VIII. Function: Extension of wrist, fingers, and thumb; abduction of thumb. Muscles arising mainly from external condyle of humerus: Extensors of carpus, fingers, and thumb; supinator.
5309 Group IX. Function: The forearm muscles act in strong grasping movements are supplemented by the intrinsic muscles in delicate manipulative movements. Intrinsic muscles of hand: Thenar eminence; short flexor, opponens, abductor and adductor of thumb; hypothenar eminence; short flexor, opponens and abductor of little finger; 4 lumbricales; 4 dorsal and 3 palmar interossei.
5310 Group X. Function: Movements of forefoot and toes; propulsion thrust in walking. Intrinsic muscles of the foot: Plantar: (1) Flexor digitorum brevis; (2) abductor hallucis; (3) abductor digiti minimi; (4) quadrates plantae; (5) lumbricales; (6) flexor hallucis brevis; (7) adductor hallucis; (8) flexor digiti minimi brevis; (9) dorsal and plantar interossei. Other important plantar structures: Plantar aponeurosis, long plantar and
calcaneonavicular ligament, tendons of posterior tibial, peroneus longus, and long flexors of great and little toes.

5311 Group XI. Function: Propulsion, plantar flexion of foot (1); stabilization of arch (2, 3); flexion of toes (4, 5); flexion of knee (6). Posterior and lateral crural muscles, and muscles of the calf: (1) Triceps surae (gastrocnemius and soleus); (2) tibialis posterior; (3) peroneus longus; (4) peroneus brevis; (5) flexor hallucis longus; (6) flexor digitorum longus; (7) popliteus; (8) plantaris.
5312 Group XII. Function: Dorsiflexion (1); extension of toes (2); stabilization of arch (3). Anterior muscles of the leg: (1) Tibialis anterior; (2) extensor digitorum longus; (3) extensor hallucis longus; (4) peroneus tertius.
5313 Group XIII. Function: Extension of hip and flexion of knee; outward and inward rotation of flexed knee; acting with rectus femoris and sartorius (see XIV, 1, 2) synchronizing simultaneous flexion of hip and knee and extension of hip and knee by belt-over-pulley action at knee joint. Posterior thigh group, Hamstring complex of 2-joint muscles: (1) Biceps femoris; (2) semimembranosus; (3) semitendinosus.
5314 Group XIV. Function: Extension of knee (2, 3, 4, 5); simultaneous flexion of hip and flexion of knee (1); tension of fascia lata and iliotibial (Maissiat’s) band, acting with XVII (1) in postural support of body (6); acting with hamstrings in synchronizing hip and knee (1, 2). Anterior thigh group: (1) Sartorius; (2) rectus femoris; (3) vastus externus; (4) vastus intermedius; (5) vastus internus; (6) tensor vaginae femoris.
5315 Group XV. Function: Adduction of hip (1, 2, 3, 4); flexion of hip (1, 2); flexion of knee (4). Mesial thigh group: (1) Adductor longus; (2) adductor brevis; (3) adductor magnus; (4) gracilis.
5316 Group XVI. Function: Flexion of hip (1, 2, 3). Pelvic girdle group 1: (1) Psoas; (2) iliacus; (3) pectineus.
5317 Group XVII. Function: Extension of hip (1); abduction of thigh; elevation of opposite side of pelvis (2, 3); tension of fascia lata and iliotibial (Maissiat’s) band, acting with XIV (6) in postural support of body steadying pelvis upon head of femur and condyles of femur on tibia (1). Pelvic girdle group 2: (1) Gluteus maximus; (2) gluteus medius; (3) gluteus minimus.
5318 Group XVIII. Function: Outward rotation of thigh and stabilization of hip joint. Pelvic girdle group 3: (1) Pyriformis; (2) gemellus (superior or inferior); (3) obturator (external or internal); (4) quadratus femoris.
5319 Group XIX. Function: Support and compression of abdominal wall and lower thorax; flexion and lateral motions of spine; synergists in strong downward movements of arm (1). Muscles of the abdominal wall: (1) Rectus abdominis; (2) external oblique; (3) internal oblique; (4) transversalis; (5) quadratus lumborum.
5320 Group XX. Function: Postural support of body; extension and lateral movements of spine. Spinal muscles: Sacrospinalis (erector spinae and its prolongations in thoracic and cervical regions).
5321 Group XXI. Function: Respiration. Muscles of respiration: Thoracic muscle group.
5322 Group XXII. Function: Rotary and forward movements of the head; respiration; deglutition. Muscles of the front of the neck: (Lateral, supra-, and infrahyoid group.) (1) Trapezius I (clavicular insertion); (2) sternocleidomastoid; (3) the “hyoid” muscles; (4) sternothyroid; (5) digastric.
5323 Group XXIII. Function: Movements of the head; fixation of shoulder movements. Muscles of the side and back of the neck: Suboccipital; lateral vertebral and anterior vertebral muscles.
5324 Diaphragm, rupture of, with herniation.
5325 Muscle injury, facial muscles.
5326 Muscle hernia, extensive.
5327 Muscle, neoplasm of, malignant (excluding soft tissue sarcoma)
5328 Muscle, neoplasm of, benign, postoperative.
5329 Sarcoma, soft tissue (of muscle, fat, or fibrous connective tissue)

__________________
Jason

Physical Evaluation Board Forum Administrator
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