HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating two class B findings on foot care procedures that describe the severity of the patient’s systemic condition without writing a narrative description. Class B findings: absent posterior tibial pulse, absent dorsalis pedis pulse, advanced trophic changes (i.e., hair growth [decrease, absence], nail changes [thickening], pigmentary changes [discoloration], skin texture [thin, shiny], and/or skin color [rubor, redness]).