Name of the Procedure:

HCPCS Code E0967 - Manual Wheelchair Accessory, Hand Rim with Projections, Any Type, Replacement Only, Each

Summary

This procedure involves the replacement of a hand rim with projections on a manual wheelchair. Hand rims with projections provide additional grip and leverage, which can be particularly beneficial for individuals with limited hand strength. This accessory helps users to better maneuver their wheelchair.

Purpose

The procedure aims to address mobility challenges faced by individuals using manual wheelchairs. It specifically helps those with compromised hand strength or dexterity to gain better control and ease of propulsion of their wheelchair.

Goals:

• Improve mobility and independence.
• Enhance comfort and usability of the manual wheelchair.
• Increase the user's ability to navigate various terrains with less effort.

Indications

• Individuals experiencing difficulty propelling their manual wheelchair due to weak grip or limited hand strength.
• Patients with conditions such as arthritis, muscular dystrophy, or spinal cord injuries that affect hand function.
• Users who require better wheelchair maneuverability and control.

Preparation

Since this is an accessory replacement procedure, extensive preparation is usually not necessary.

Instructions:

• Ensure the wheelchair is in good working condition.
• Review any current equipment and note the specifications for compatibility.
• Confirm the need for replacement due to wear and tear or user discomfort.

No specific diagnostic tests are required beforehand.

Procedure Description

1. The wheelchair is inspected to determine the condition of the existing hand rims and the compatibility of the new hand rim with projections.
2. The existing hand rims are removed using appropriate tools, such as screwdrivers or wrenches.
3. The new hand rims with projections are aligned and attached to the wheelchair wheels.
4. Ensure they are securely fastened and test for stability and functionality.

Tools/Equipment:

• Screwdrivers, wrenches, and possibly an Allen key set.
• New hand rims with projections.

No anesthesia or sedation is necessary for this procedure.

Duration

Typically, the replacement process takes about 30 minutes to an hour.

Setting

The procedure is usually performed in an outpatient clinic, a rehabilitation center, or even at the patient’s home by a trained technician.

Personnel

• A trained wheelchair technician or a rehabilitation specialist will typically perform the procedure.
• Occasionally, the involvement of an occupational therapist may be required for tailored adjustments based on the patient's specific needs.

Risks and Complications

• Improper installation could lead to instability or difficulty in wheelchair maneuverability.
• Skin irritation or blisters on the hands from new projections.
• Occasional need for adjustment if the initial fit is not perfect.

Management:

• Regular follow-ups to ensure proper fitting.
• Assess and address any discomfort reported by the user.

Benefits

• Improved control and ease of wheelchair propulsion.
• Reduced strain on the hands and arms.
• Enhanced independence and potential for a more active lifestyle.

Users often realize these benefits immediately after the new hand rims are installed.

Recovery

Post-procedure care:

• Monitoring for any discomfort or issues for a few days.
• No significant recovery period is expected.

Follow-up:

• Typically, follow-up appointments may be scheduled to ensure the user's comfort and address any issues.

Alternatives

• Rubber-coated or foam-padded hand rims for better grip without projections.
• Power-assist devices for manual wheelchairs.
• Custom grip gloves designed to improve traction and control.

Pros and Cons:

• Alternatives may offer different levels of comfort and ease of use.
• Power-assist devices are more costly and may require additional maintenance.

Patient Experience

During the procedure:

• Minimal discomfort, as the process involves mechanical adjustments to the wheelchair.

After the procedure:

• Users may feel an immediate improvement in maneuverability.
• Initial adjustment period to adapt to the new grip and control.
• Any discomfort can be managed with appropriate gloves or padding.

Pain Management:

• Typically, no pain unless there are pre-existing hand issues.
• Optionally, users can be advised on using grip gloves to reduce friction and increase comfort.