Case Logging Guide

Importance of Accurate Case Logging

Accurate case logging in the Podiatry Logging Service (PLS) is critical to your success in the certification process. Logging ensures that ABFAS has a complete and reliable record of the surgical procedures you have performed as the surgeon of record after residency, including those completed during a fellowship. Incomplete or inaccurate logging may negatively affect your Case Review outcome. By carefully documenting your cases, you help ensure a smooth review process and provide the strongest representation of your surgical training and practice.

Please remember to log into PLS all post-residency surgical procedures that you performed as surgeon of record. If, however, you are already certified in Foot Surgery and seeking only RRA Surgery certification, you may log only post-residency RRA procedures.

Important to know: Follow all instructions carefully to optimize your chances of successfully passing Case Review.

Please ensure that you correctly log procedures into PLS. Case reviewers evaluate cases based on the category you have assigned. For example, if a joint salvage procedure with cheilectomy only is logged as a joint salvage procedure with distal metatarsal osteotomy, you will receive a low or failing score for that case. Open management of fracture or MTPJ dislocation cases must include internal or external fixation. Cases are evaluated based on pre-operative clinical assessment, diagnosis and interpretive skills, surgical indications, technical skill, post-operative management, complications, and outcomes.

PLS Logging Checklist

• Ensure that you log cases using the correct procedure code in PLS. Note: Failure to correctly log procedure type is a common error. Mislogging is one of the major reasons candidates fail Case Review.
  
• Ensure that you are listed as the only Surgeon (not Co-surgeon, Assistant Surgeon, or any other designation) on all operative reports and all chart materials for every procedure you log.
• Ensure that you are listed as the surgeon of record (not co-surgeon) in the intraoperative anesthesia record or circulating nurse’s notes. 
• List every procedure performed and documented in the operative report.

 

Common Logging Errors

Mislogging is one of the major reasons why candidates fail Case Review. Pay close attention to ensure you log each case accurately. Below is a list of common logging errors that resulted in candidates failing Case Review:

1. Lisfranc fracture ORIF or arthrodesis. Please note: "Midfoot" joint(s) refers to any joint proximal to, and not including, tarsometatarsal/Lisfranc joint.
   • A Lisfranc fracture repair or arthrodesis is not considered a rearfoot procedure. Log an ORIF as 4.13 (Open management of tarsometatarsal fracture/dislocation) and a Lisfranc joint arthrodesis (with or without ORIF) as a 4.15 (tarsometatarsal fusion) an intercuneiform stabilization/arthrodesis should not be logged or documented separately.
   • The correct code for isolated Lisfranc reduction with suture button fixation without any osseous fractures is 3.7 (open management of dislocation) as the procedure focuses on soft tissue ligamentous repair of the Lisfranc injury).
   • If there is a ligament injury as well as osseous fractures where you have performed an actual reduction of bone fracture/displacement/joint dislocation via an open incision, the procedure code is 4.13.
     
     
2. A Lapidus bunionectomy is a first-ray procedure and log only as 2.1.6 (bunionectomy with first metatarsocuneiform fusion) or 2.2.5 (joint salvage with first metatarsocuneiform fusion) or 2.3.3 (metatarsocuneiform fusion, other than for hallux valgus or hallux limitus) an intercuneiform stabilization/arthrodesis should not be logged or documented separately.
   
   
3.  A Haglund's deformity where the posterior heel exostosis is shaved (without detaching and reattaching a major portion of the Achilles tendon) is a 4.1 (partial ostectomy). If removal of the bone spur includes detachment and reattachment of the Achilles, you must use 4.19.
   
   
4. Plastic surgery does not include wound debridement and synthetic/biological graft application. A synthetic/biological graft application and/or double elliptical lesion excision does not meet the criteria for Case Review.
   
   
5. A Kidner procedure correct code is either as 5.1.6 (tendon augmentation/supplementation/restoration) or 3.1 (excision of ossicle without tendon advancement). Do not log as both 5.1.6 and 3.1 as 5.1.6 includes the ossicle excision. Removal of any ossicle/fracture fragment such as os peroneum, os trigonum, or os navicularis is only a 3.1.
   
   
6. Do not log a cheilectomy separately if done in conjunction with another 1st metatarsal procedure (osteotomy or TMTJ fusion). Only one category 2 procedure can be logged at the same time.
   • 2.2.1 An isolated cheilectomy as a joint salvage procedure.
   • 2.2.3 A cheilectomy is done in combination with a distal metatarsal osteotomy.
   • 2.2.4 A cheilectomy is done in combination with a metatarsal shaft or base osteotomy.
   • 2.2.5 A cheilectomy is done in conjunction with a first TMT joint fusion.
     
     
7. In cases where a subchondroplasty procedure/insufficiency fractures with curettage and/or injection of biologics are performed as part of another procedure, only the index procedure must be logged. For example, a talar dome or distal tibial subchondroplasty may only be logged as:
   • 5.2.7 open management of talar dome lesion (with or without osteotomy), or
   • 5.2.8 ankle arthrotomy with removal of loose body or other osteochondral debridement
     
     If performed in isolation, use of one of the following subcategories:
     
     
   • 1.13 other osseous digital procedure not listed above
   • 2.3.10 other first ray procedure not listed above
   • 4.18 other osseous procedures not listed (distal to the tarsometatarsal joint)
   • 5.2.11 other elective reconstructive rearfoot/ankle osseous surgery not listed above
     
     
8. Log treatment of a dislocating peroneal tendon (including fibular groove deepening) as 5.1.6 (tendon augmentation/supplementation/restoration), not as an osteotomy.
   
   
9. Log isolated syndesmotic ankle repair as 5.3.2, (repair of acute ligament injury). This category cannot be combined with 5.4.3 (open repair of adult ankle fracture) or 5.4.4 (open repair of pediatric rearfoot/ankle fracture or dislocation).
   
   
10. Log 5th metatarsal bunionectomy without osteotomy as a 4.3 (bunionectomy of the fifth metatarsal without osteotomy). If a fifth metatarsal osteotomy with osseous realignment is performed, then the correct code is 4.7 (bunionectomy of the fifth metatarsal with osteotomy).