15.29 Summary
Table 15-19: DBI Table Digit/Hand Impairment
Table 15-20: DBI Table Wrist Impairment
Table 15-21: DBI Table Elbow Impairment
Table 15-22: DBI Table Shoulder Impairment
Table 15-23f: DBI Table Digital Nerve Sensory Impairment
Table 15-23h: DBI Table Sensory-Only Peripheral Nerve Impairment
Table 15-23i: DBI Table Peripheral Nerve Impairment
Table 15-23j: DBI Table Brachial Plexus Impairment
Table 15-23k: DBI Table Entrapment Neuropathy Impairment
Table 15-23r: DBI Table Thoracic Outlet Syndrome Impairment
Table 15-25: DBI Table Amputation Impairment Upper Limb
Table 15-26: DBI Table Vascular Impairment Upper Limb
Table 15-27: DBI Table Complex Regional Pain Syndrome (CRPS) Impairment
Table 15-19: DBI Table Digit/Hand Impairment
- 15-19-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-19-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-19-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-19-03 Soft Tissue Disease or Event Healed Superficial or Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-19-04 Soft Tissue Disease or Event Healed Nonsuperficial
- 15-19-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Digit/Hand
- 15-19-06 Digital Stenosing Tenosynovitis, Trigger Digit
- 15-19-07 Dupuytren's Contracture*
- 15-19-08 Arthritis Posttraumatic Without ROM Loss, Reported by Joint (IP, DIP, PIP, MCP)
- 15-19-09 Instability Thumb IP Joint or Finger DIP Joint (eg, dislocation with residual)
- 15-19-10 Instability Finger PIP Joint (eg, dislocation with residual)
- 15-19-11 Instability Finger MCP Joint (eg, dislocation with residual)
- 15-19-12 Instability Thumb MCP Joint (eg, dislocation with residual)
- 15-19-13 Instability Thumb CMC Joint (eg, dislocation with residual)
- 15-19-14 Flexor Thumb IP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-15 Flexor Thumb MCP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-16 Flexor Finger DIP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-17 Flexor Finger PIP With ROM Loss (flexor tendon rupture/laceration)
- 15-19-18 Flexor Finger MCP With ROM Loss (flexor tendon rupture/laceration)
- 15-19-19 Extensor Thumb IP Joint With ROM Loss (flexor tendon rupture/laceration, posttraumatic tendon adhesions)
- 15-19-20 Extensor Thumb MCP Joint With ROM Loss (extensor tendon rupture/laceration)
- 15-19-21 Extensor Finger DIP Joint With ROM Loss (extensor tendon rupture/laceration)
- 15-19-22 Extensor Finger PIP With ROM Loss (extensor tendon rupture/laceration)
- 15-19-23 Extensor Finger MCP With ROM Loss (extensor tendon rupture/laceration)
- 15-19-24 Joint Stiffness Thumb IP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-25 Joint Stiffness Thumb MCP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-26 Joint Stiffness Thumb CMC ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-27 Joint Stiffness Finger DIP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-28 Joint Stiffness Finger PIP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-29 Joint Stiffness Finger MCP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-30 Arthrodesis Thumb IP Joint171,172
- 15-19-31 Arthrodesis Thumb MCP Joint
- 15-19-32 Arthrodesis Thumb CMC Joint
- 15-19-33 Arthrodesis Finger DIP Joint
- 15-19-34 Arthrodesis Finger PIP Joint
- 15-19-35 Arthrodesis Finger MCP Joint
- 15-19-36 Arthroplasty Thumb IP Joint
- 15-19-37 Arthroplasty Thumb MCP Joint
- 15-19-38 Arthroplasty Thumb CMC Joint
- 15-19-39 Arthroplasty Finger DIP Joint*
- 15-19-40 Arthroplasty Finger PIP Joint*
- 15-19-41 Arthroplasty Finger MCP Joint*
- 15-19-42 Fracture Thumb Distal Phalanx*
- 15-19-43 Fracture Thumb Proximal Phalanx*
- 15-19-44 Fracture Thumb Metacarpal*
- 15-19-45 Fracture Thumb Metacarpal Base173 (intraarticular CMC joint)*
- 15-19-46 Fracture Finger Distal Phalanx*174
- 15-19-47 Fracture Finger Middle Phalanx*
- 15-19-48 Fracture Finger Proximal Phalanx*
- 15-19-49 Fracture Finger Metacarpal*175,176
Table 15-20: DBI Table Wrist Impairment
- 15-20-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-20-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-20-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-20-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-20-04 Soft Tissue Disease or Event Healed Nonsuperficial*
- 15-20-05 Wrist Sprain, Strain, Specific Traumatic Event, de Quervain's, Intersection Syndrome, Tendonitis, Tendinosis, Nonspecific Tendonitis of Wrist and/or Forearm177,178
- 15-20-06 Wrist/Forearm Mass or Ganglion Cyst (FCR mass, EDC mass, including recurrent mass, etc)179,180
- 15-20-07 Triangular Fibrocartilage Complex (TFCC) Event181,182
- 15-20-08 Ulnar Impaction
- 15-20-09 Posttraumatic Arthritis Wrist Without ROM Loss
- 15-20-10 Forearm Radial, Ulna, or Both Fracture Without ROM Loss
- 15-20-11 Instability Dorsal Intercalated Segment Instability (DISI) (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183
- 15-20-12 Instability Volar Intercalated Segment Instability (VISI) (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183
- 15-20-13 Instability Scapholunate Ligament (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183-185
- 15-20-14 Instability Peri-Lunate (eg, dislocation with residual)183
- 15-20-15 Instability Carpal Complex (eg, dislocation with residual)183
- 15-20-16 Instability Distal Radioulnar Joint (DRUJ) (eg, dislocation with residual, isolated ulnar head injury, after the Sauvé-Kapandji procedure)183,185,186
- 15-20-17 Ruptured or Laceration Muscle Tendon (Flexor or Extensor) Without ROM Loss
- 15-20-18 Flexor With ROM Loss Wrist (from flexor tendon rupture/laceration
- 15-20-19 Extensor With ROM Loss Wrist (from extensor tendon rupture/laceration)
- 15-20-20 Joint Stiffness Wrist With ROM Loss
- 15-20-21 Avascular Necrosis (AVN) of Lunate (Kienböck's disease with possible dislocation, fracture, fracture dislocation, malunion, nonunion with residual)187,188
- 15-20-22 Arthroplasty Wrist189
- 15-20-23 Arthrodesis Wrist190
Table 15-21: DBI Table Elbow Impairment
- 15-21-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-21-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-21-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-21-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-21-04 Soft Tissue Disease or Event Healed Nonsuperficial*
- 15-21-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Elbow
- 15-21-06 Olecranon Bursitis
- 15-21-07 Epicondylitis Medial or Lateral
- 15-21-08 Distal Biceps Tendon Rupture194,195
- 15-21-09 Instability Elbow Collateral Ligament Event With Medial (Ulnar), Lateral, or Posterolateral196
- 15-21-10 Posttraumatic Elbow Arthritis Without ROM Loss
- 15-21-11 Ruptured or Lacerated Muscle or Tendon Without Limited ROM
- 15-21-12 Joint Stiffness Elbow With ROM Loss (from arthritis or arthrofibrosis [ie, posttraumatic, septic, gouty, rheumatoid], tendon adhesions, fracture [ie, radius, ulnar, distal humerus])
- 15-21-13 Loose Bodies or Osteochondral Lesions (not bone spur)
- 15-21-14 Heterotopic Ossification Elbow Without Limited ROM
- 15-21-15 Arthroplasty Radial Head (isolated)
- 15-21-16 Radial Head Resection*
- 15-21-17 Arthroplasty Total Elbow (total, soft tissue, prosthesis, or Kashiwagi-Outerbridge)*197
- 15-21-18 Arthrodesis Elbow198
- 15-21-19 Fracture Radial Head*199
- 15-21-20 Radial Shaft Fracture Without ROM Loss
- 15-21-21 Ulna Shaft Fracture Without ROM Loss
- 15-21-22 Radial and Ulnar Shaft Fracture Without ROM Loss
Table 15-22: DBI Table Shoulder Impairment
- 15-22-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-22-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-22-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-22-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-22-04 Soft Tissue Disease or Event Healed Nonsuperficial
- 15-22-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Shoulder
- 15-22-06 Shoulder Bursitis or Impingement Syndrome With No ROM Loss or Instability200,201
- 15-22-07 Heterotopic Ossification or Calcific Tendinitis
- 15-22-08 Posttraumatic Shoulder Arthritis Without ROM Loss
- 15-22-09 Partial Rotator Cuff Disease202,203
- 15-22-10 Full Rotator Cuff Disease204-212
- 15-22-11 Labral Lesions and Superior Labrum From Anterior to Posterior (SLAP) Lesions
- 15-22-12 Long Head Biceps (dislocation/subluxation/rupture)
- 15-22-13 AC Joint Separation213,214
- 15-22-14 Instability Unidirectional or Multidirectional, Dislocation, and Hill-Sachs Lesion (subluxation, see shoulder sprain, strain)
- 15-22-15 Instability Multidirectional Bilateral
- 15-22-16 Joint Stiffness Shoulder With ROM Loss (from arthritis [ie, posttraumatic, septic, gouty, rheumatoid], tendon adhesions, fracture [ie, proximal humerus], adhesive capsulitis, frozen shoulder)
- 15-22-17 Loose Bodies or Chondral Lesions (not bone spur)
- 15-22-18 Arthrodesis Shoulder
- 15-22-19 Arthroplasty Shoulder (total shoulder arthroplasty [TSA] or reverse total shoulder arthroplasty [RSA])215,216
- 15-22-20 Arthroplasty Shoulder (resection)217
- 15-22-21 Arthroplasty Shoulder (hemiCAP or resurfacing)218,219
- 15-22-22 Hemiarthroplasty Shoulder220
- 15-22-23 Fracture Humeral Shaft Without ROM Loss
- 15-22-24 Fracture Scapula (body, neck, coracoid process) Without ROM Loss
- 15-22-25 AVN Humeral Head Without ROM Loss
- 15-22-26 Distal Clavicle Resection (Acromioplasty)221,222
Table 15-23f: DBI Table Digital Nerve Sensory Impairment
- 15-23f-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23f-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23f-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23f-03 Transverse Digital Nerve Loss Distal to Thumb IP Joint or Distal to Finger PIP Joint
- 15-23f-04 Longitudinal Digital Nerve Loss Distal to Thumb IP Joint or Distal to Finger PIP Joint
- 15-23f-05 Transverse Digital Nerve Loss Distal to Thumb MCP Joint or Distal to Finger MCP Joint
- 15-23f-06 Longitudinal Digital Nerve Loss Distal to Thumb MCP Joint or Distal to Finger MCP Joint
Table 15-23h: DBI Table Sensory-Only Peripheral Nerve Impairment
- 15-23h-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23h-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23h-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23h-03 Sensory-Only Peripheral Nerve Impairment (List)
- 15-23h-04 Thumb Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15-23h-05 Index/Middle Finger Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15-23h-06 Ring/Little Finger Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15.23i1 Sensory and Motor Assessment Levels
- 15.23i2 Steps for Peripheral Nerve Injury Rating
- 15.23i3 Steps for Brachial Plexus Injury Rating
- 15.23i4 Cutaneous Innervation of the Upper Limb
- 15.23i5 Motor Innervation of the Upper Limb
DBI Table 15-23i Peripheral Nerve Impairment
- 15-23i-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23i-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23i-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23i-03 Pectoralis (medial or lateral)
- 15-23i-04 Axillary
- 15-23i-05 Dorsal Scapular
- 15-23i-06 Long Thoracic
- 15-23i-07 Median Above Mid-forearm
- 15-23i-08 Median Anterior Interosseous Branch
- 15-23i-09 Median Below Mid-forearm—Entire Nerve (traditionally palmar digit thumb, middle, and/or radial ring) (Note: Use DBI Table 15-23k for carpal tunnel syndrome entrapment neuropathy)
- 15-23i-10 Musculocutaneous
- 15-23i-11 Radial Upper Arm With Loss of Triceps
- 15-23i-12 Radial Elbow With Sparing of Triceps
- 15-23i-13 Subscapulars (upper and lower)
- 15-23i-14 Suprascapular
- 15-23i-15 Thoracodorsal
- 15-23i-16 Ulnar Above Mid-forearm
- 15-23i-17 Ulnar Below Mid-forearm—Entire Nerve (traditionally palmar digit ulnar ring and little finger) (Note: Use DBI Table 15-23k for cubital tunnel syndrome entrapment neuropathy)
- 15-23i-18 Diabetic Neuropathy
Table 15-23i: DBI Table Peripheral Nerve Impairment
- 15-23j-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23j-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23j-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23j-03 Brachial Plexus (C5 through T1)
- 15-23j-04 Upper Trunk (C5, C6, Erb-Duchene)
- 15-23j-05 Middle Trunk (C7)
- 15-23j-06 Lower Trunk (C8, T1, Dejerine-Klumpke)
Table 15-23k: DBI Table Entrapment Neuropathy Impairment
- 15-23k-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23k-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23k-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23k-03 Median Nerve Wrist (carpal tunnel syndrome)
- 15-23k-04 Median Nerve Forearm (anterior interosseous syndrome or pronator syndrome)
- 15-23k-05 Ulnar Nerve Wrist (Guyon's canal syndrome)
- 15-23k-06 Ulnar Nerve Elbow (cubital tunnel syndrome)
- 15-23k-07 Radial Nerve Wrist Forearm (Wartenberg's syndrome)
- 15-23k-08 Radial Nerve Elbow (radial tunnel syndrome or posterior interosseous of proximal forearm syndrome)
Table 15-23r: DBI Table Thoracic Outlet Syndrome Impairment
- 15-23r-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23r-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23r-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23r-03 Thoracic Outlet Syndrome Neurogenic
- 15-23r-04 Thoracic Outlet Syndrome Vascular (Arterial)
- 15-23r-05 Thoracic Outlet Syndrome Vascular (venous)
Table 15-25: DBI Table Amputation Impairment Upper Limb
- 15.25d Thumb/Finger Amputations: Details and Associated Conditions
- 15.25e Phalange and/or Metacarpal Amputations and Associated Conditions
- 15.25f Carpal-Metacarpal Joint to Shoulder: Details and Associated Conditions
Table 15-26: DBI Table Vascular Impairment Upper Limb
- 15-26-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-26-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-26-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-26-03 Vascular Condition of Digits/Hand*
- 15-26-04 Vascular Condition of Upper Limb*
Table 15-27: DBI Table Complex Regional Pain Syndrome (CRPS) Impairment
- 15-27-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-27-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-27-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-27-03 Complex Regional Pain Syndrome (CRPS)
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