Current RMA Instruments:

Changes from previous Instruments

SOP Bulletin 159

ICD Coding

• ICD-9-CM Codes: 734,754.61
• ICD-10-AM Codes: M21.4, Q66.5

Brief description

Pes planus is flat feet, where the longitudinal arch of the foot doesn't develop normally during childhood, or does form and is subsequently lost or partially lost due to disease or injury affecting the anatomical structures that form the arch.  This condition can be congenital, development or acquired.  ‘Congenital’ is present at birth. ‘Developmental’ occurs during the period of development (from birth to complete adulthood). In this SOP ‘congenital’ covers both congenital and developmental.

Confirming the diagnosis

Diagnosis of pes planus is made on clinical grounds, based on the appearance of the foot on weight bearing.  Establishing whether the pes planus is congenital/developmental or acquired may be more difficult.  Most cases are developmental.  Some evidence of a normal longitudinal arch having been lost following disease or injury affecting the foot will be required to establish that the condition is acquired.

The relevant medical specialist is an orthopaedic surgeon.

Additional diagnoses covered by SOP

• Flat feet

Conditions excluded from SOP

• Plantar fasciitis*
• Pes cavus^#

* another SOP applies

^# non-SOP condition

Clinical onset

The longitudinal arch of the foot normally develops in children at around age 3 to 5 years.  Clinical onset may be in childhood, when it becomes apparent that the arch has failed to develop, or may be later in life if due to an acquired cause. 

Clinical worsening

Clinical worsening may be evidenced by progression from flexible to rigid pes planus or an increase in the level of symptoms (pain) attributed to the condition.