Name of the Procedure:

Continuous Passive Motion (CPM) Exercise Device for Use Other Than Knee (HCPCS Code: E0936)

Summary

The Continuous Passive Motion (CPM) exercise device is a mechanical device designed to move a joint continuously through a controlled range of motion. Unlike CPM machines specifically designed for knee rehabilitation, the E0936 code pertains to the use of CPM devices for joints other than the knee.

Purpose

This device aims to aid in the recovery and rehabilitation of joints following surgery or injury. It helps to maintain and increase the range of motion, reduce pain and swelling, prevent joint stiffness, and enhance healing.

Indications

• Post-operative rehabilitation for joints such as shoulder, elbow, wrist, ankle, or hip.
• Recovery from joint surgeries or injuries.
• Conditions like joint contractures where increased range of motion is required.

Preparation

• No special pre-procedure preparation is typically required.
• Patients might be advised to wear comfortable clothing.
• Consultation with the healthcare provider to assess specific medical conditions or medication adjustments might be necessary.

Procedure Description

1. Setup: The patient is seated or lying down comfortably.
2. Device Placement: The CPM device is positioned around the joint to be treated.
3. Settings Adjustment: The device settings are adjusted to control the range of motion and speed according to the patient’s comfort and therapy goals.
4. Operation: The device gradually moves the joint through a prescribed range of motion.
5. Duration: Sessions can vary but typically last between 20 minutes to an hour based on physician recommendations.
6. Monitoring: The healthcare provider or a caregiver monitors the device's operation and the patient’s comfort.

Tools and Equipment:

• CPM machine tailored to the specific joint.

Anesthesia or Sedation:

• Typically, no anesthesia or sedation is required.

Duration

Each session usually lasts from 20 minutes to an hour, depending on the treatment plan.

Setting

• Outpatient clinics.
• Physical therapy centers.
• Home settings, under professional supervision.

Personnel

• Physical therapist or trained healthcare professional.
• In certain cases, caregivers after appropriate training.

Risks and Complications

• Common: Mild discomfort during initial use.
• Rare: Skin irritation, increased swelling, or muscle spasm if not properly monitored. Management of complications generally involves adjusting the device settings or taking breaks during the session.

Benefits

• Enhanced joint flexibility and range of motion.
• Reduced post-operative pain and swelling.
• Minimized risk of joint stiffness and contractures. Realization of benefits varies but improvements are often noticed within a few weeks of regular use.

Recovery

• No specific recovery period required post-session.
• Patients may need to continue using the device for several weeks or months.
• Follow-up appointments with healthcare providers to assess progress.
• Patients are encouraged to continue performing any prescribed physical activities or exercises.

Alternatives

• Manual physical therapy.
• Active range of motion exercises.
• Surgical interventions for severe joint issues. Pros and Cons:
• CPM offers passive, controlled movement with minimal effort from the patient, which can be beneficial for those with severe pain or limited mobility.
• Manual therapy might provide more personalized adjustments but requires physical exertion and therapist availability.

Patient Experience

During the procedure, patients might initially feel unfamiliar but should not experience pain. Mild discomfort may occur as the joint adjusts to movement. Post-session, the joint might feel more flexible and less painful over time. Adequate comfort measures and pain management are provided as needed to ensure a tolerable experience.