Pumps in Clinic Use

Pneumatic pumps are helpful in the clinic to add an extra pair of hands while working with a patient and can be billed to Medicare. Specific documentation is needed while using pneumatics in the clinic. See below to add to your documentation template or other format. NOTE: you have to measure both limbs before the use of pump, document the "after" measures on the limb that used the pump. 

Reason for use of pneumatic pump:





Body part provided with pneumatic support:






Type of pneumatic pump:


Level of pressure:



Measurements of body part before (use at least three sections, mark with eyeliner pencil):

Midfoot   Ankle     Calf   Thigh

Palm  Wrist   Upper Forearm   Biceps

Measurements of body part after:

Midfoot   Ankle     Calf   Thigh

Palm   Wrist   Upper Forearm   Biceps

Calculations for showing change:

Patients Response (examples):