For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material...
HCPCS code
Name of the Procedure:
Custom Multiple Density Foot Insert Creation (HCPCS A5514)
Summary
Using advanced computer-aided manufacturing (CAM) technology, this procedure creates a custom multiple density foot insert tailored to a diabetic patient's foot. The insert is crafted by direct carving from a rectified computer-aided design (CAD) model, which is derived from a digitized scan of the patient's foot. This ensures total contact with the patient's foot, including the arch, and is made with a base layer of at least 3/16 inch material.
Purpose
The HCPCS A5514 procedure addresses diabetic foot complications, aiming to provide optimal pressure distribution, enhance foot function, and prevent foot ulcers and other complications. The primary goal is to create a custom-fit insert that aligns perfectly with the patient's foot anatomy, improving comfort and reducing the risk of injuries.
Indications
- Diabetic neuropathy or foot complications
- Foot ulcers or high risk of developing ulcers
- Pressure points or poor circulation in the feet
- Any other condition requiring customized foot support for diabetics
Preparation
- No special pre-procedure instructions, fasting, or medication adjustments required.
- A comprehensive assessment and foot scan to gather precise measurements and anatomical details.
Procedure Description
- Assessment and Scanning: The patient's foot is assessed and digitally scanned to capture detailed measurements.
- CAD Model Creation: A precise CAD model of the foot is generated.
- Direct Carving with CAM: The custom insert is manufactured by direct carving from the CAD model using CAM technology.
- Final Adjustments and Fitting: The completed insert is checked for accuracy, adjusted if necessary, and fitted to ensure total contact with the foot, including the arch.
Duration
The entire process, from scanning to fitting, typically takes a few days to a week. Each in-session step (like scanning and final fitting) takes about 30-60 minutes.
Setting
- Outpatient clinic specializing in podiatry or diabetic care
- Orthotic and prosthetic facilities
Personnel
- Certified podiatrists or orthotists
- Technicians specialized in CAD/CAM technology
Risks and Complications
- Minimal risks, as the procedure is non-invasive.
- Possible minor discomfort during initial wearing periods.
- Adjustment needs if discomfort or improper fit occurs.
Benefits
- Enhanced foot support and pressure distribution
- Improved comfort and prevention of foot complications
- Personalized fit that caters specifically to the patient’s anatomy
Recovery
- Immediate use post-fitting
- Gradual wear adjustment as recommended by the specialist
- Follow-up appointments to monitor fit and function
Alternatives
- Standard pre-fabricated inserts
- Pros: Readily available, lower cost
- Cons: Lack of custom fit, less effective for severe conditions
- Custom orthotic inserts made with traditional methods
- Pros: Tailored to the individual
- Cons: May not offer the precision and comfort of CAD/CAM technology
Patient Experience
During the procedure, patients will experience a non-invasive foot scan. Initially, they may feel slight pressure or discomfort while adjusting to the new inserts. Pain management is typically not necessary, as the procedure is painless and adjusts such discomforts during follow-ups.