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Non-freezing cold injury S012

Last amended 
9 January 2018
Current RMA Instruments
Reasonable Hypothesis SOP
25 of 2018
Balance of Probabilities SOP
26 of 2018
Changes from previous Instruments

SOP Bulletin 200

ICD Coding
  • ICD-9-CM Codes: 991.4
  • ICD-10-AM Codes: T69.0
Brief description

This condition most commonly involves the foot but may also involve other parts of the lower limbs and also the upper limbs.  It occurs following exposure of the affected body part for a prolonged time period to wet and cold but not freezing temperatures. The pathology chiefly involves the skin and the local vascular and sympathetic nervous systems and chronic problems (including pain and cold sensitisation) may develop.

Confirming the diagnosis

Diagnosis is made on clinical grounds.

Additional diagnoses covered by SOP
  • Trench foot
  • Immersion foot
Conditions not covered by SOP
  • Chilblains*
  • Frostbite*
  • Pernio* - chilblains SOP
  • Tropical immersion foot#
  • Paddy foot#
  • Warm water immersion foot#

* another SOP applies

# non-SOP condition 

Clinical onset

Clinical onset will be when relevant symptoms (prolonged pain, redness and swelling of skin) first began, and within 24 hours of the relevant exposure to wet and cold conditions.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Slow rewarming after cold/wet exposure may be helpful.  Once the condition is present there is little in the way of effective treatment, other than pain control, that can be offered.


Tropical immersion foot or paddy foot is an injury that occurs after several days of warm water immersion.  It is a non-SOP condition.  The pathology is hydration of the stratum corneum of the skin with no associated vascular or nervous damage.  Recovery generally occurs in no more than 4 or 5 days, with the most severely affected patients healed completely within 10 to 12 days, without serious sequelae.