Name of the Procedure:

Wheelchair Foot Box Installation (HCPCS Code E0954)

Summary

The installation of a wheelchair foot box involves attaching a supportive device to the wheelchair to properly position and support the patient's feet. This accessory includes all necessary attachment and mounting hardware for each foot.

Purpose

Medical Conditions

• Neuromuscular disorders
• Lower limb deformities
• Poor postural alignment
• Spasticity

Goals

• Improve foot stability and position
• Enhance comfort
• Prevent or minimize foot deformities
• Provide better overall support and mobility

Indications

Symptoms and Conditions

• Foot drop
• Muscle spasticity
• Impaired foot positioning
• Poor balance and stability in the wheelchair

Patient Criteria

• Patients who use a wheelchair for long durations
• Individuals with specific lower limb positioning needs
• Patients experiencing discomfort or instability due to foot placement

Preparation

Instructions for Patient

• No specific fasting or medication adjustments required.
• Wear comfortable, loose clothing if a fitting session is needed.
• Provide medical history related to foot and lower limb conditions.

Pre-procedure Assessments

• Evaluation by a physician or physical therapist.
• Measurement and fitting sessions may be required to customize the foot box.

Procedure Description

Step-by-Step Explanation

1. Assessment: A healthcare provider assesses the patient’s needs and foot positioning requirements.
2. Measurement and Fitting: Proper measurements are taken to ensure the foot box fits correctly.
3. Attachment and Mounting: The foot box is securely attached to the wheelchair using the provided hardware.
4. Adjustment: The foot box is adjusted for comfort and proper alignment.
5. Evaluation: Post-installation evaluation to ensure the foot box meets the patient's needs and provides the desired support.

Tools and Equipment

• Foot box accessory
• Attachment and mounting hardware
• Basic tools (screwdrivers, wrenches)

Anesthesia/Sedation

• Not applicable

Duration

• Typically takes 30 minutes to 1 hour.

Setting

• Performed in an outpatient clinic, wheelchair fitting center, or at home by a trained professional.

Personnel

• Physical or occupational therapist
• Wheelchair technician

Risks and Complications

Common Risks

• Minor discomfort during adjustment period
• Hardware becoming loose over time

Rare Risks

• Skin irritation or pressure sores
• Misalignment leading to discomfort or poor posture

Management

• Regular follow-ups for adjustments
• Address any discomfort immediately with healthcare provider

Benefits

Expected Benefits

• Enhanced foot support and positioning
• Improved comfort and stability in the wheelchair
• Prevention of foot deformities

Timeline for Benefits

• Immediate improvement in foot positioning
• Long-term benefits with consistent use

Recovery

Post-Procedure Care

• Regularly check attachment points for stability
• Report any discomfort or issues to a healthcare provider

Recovery Time

• No recovery time; benefits are realized immediately
• Adjustments might be needed over time

Restrictions and Follow-Up

• Minimal restrictions, normal wheelchair use can continue
• Follow-up appointments for adjustments

Alternatives

Other Treatment Options

• Custom foot orthotics
• Ankle-foot orthoses (AFOs)
• Manual foot positioning techniques

Pros and Cons

• Custom Orthotics: Highly personalized but more costly and require fitting.
• AFOs: Provide extensive support but may be uncomfortable for some users.
• Manual Techniques: Low cost but less consistent and reliable.

Patient Experience

During the Procedure

• Generally, the procedure is non-invasive and involves only mild adjustments.
• Minimal discomfort during the fitting process.

After the Procedure

• May experience an adjustment period with minor discomfort.
• Usually no significant pain; any discomfort should be reported to the healthcare provider for adjustment.
• Pain management typically not required, but over-the-counter pain relief can be used if necessary.