Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction
HCPCS code
Name of the Procedure:
Common Name(s): Power Wheelchair with Tilt and Recline Function
Technical/Medical Term: Power Seating System, Combination Tilt and Recline, with Power Shear Reduction (HCPCS Code: E1008)
Summary
A power seating system with tilt and recline functions for a wheelchair allows the user to change their position, enhancing comfort and reducing the risk of pressure sores. The power shear reduction feature ensures the user doesn't slide out of the chair during adjustments.
Purpose
Medical Conditions Addressed:
- Severe mobility limitations
- Muscle weakness or paralysis
- Risk of pressure ulcers
- Poor posture resulting from neurological or orthopedic conditions
Goals/Expected Outcomes:
- Improved comfort and pressure relief
- Enhanced mobility and independence
- Reduced risk of secondary complications such as skin breakdown and joint contractures
- Better positioning for social interaction and activity participation
Indications
Specific Symptoms or Conditions:
- Inability to perform manual repositioning within a standard wheelchair
- Existing pressure injuries or high risk for pressure sores
- Severe spasticity or muscle tone abnormalities
- Conditions like spinal cord injury, muscular dystrophy, cerebral palsy, multiple sclerosis
Patient Criteria:
- Physician assessment confirming need
- Inability to achieve functional seating with standard wheelchair features
- Ability to safely operate power controls
Preparation
Pre-procedure Instructions:
- No specific fasting or medication adjustments required
- Ensure a thorough evaluation by a seating specialist or occupational therapist
- Measurement of patient’s physical dimensions and flexibility
Diagnostic Tests/Assessments:
- Seating assessment to determine functional needs
- Pressure mapping to identify high-risk areas for pressure sores
Procedure Description
Step-by-Step Explanation:
- Assessment: Comprehensive evaluation by a healthcare provider to determine the patient's needs.
- Customization: Based on the assessment, a customized power seating system is configured, incorporating tilt, recline, and shear reduction capabilities.
- Fitting: The patient tries out the system to ensure a proper fit and comfort.
- Training: Patient and caregivers receive training on operating the system safely.
Tools & Technology Used:
- Power-adjustable wheelchair base
- Electronic tilt and recline systems
- Sensors for shear reduction
- Operating controls suited to the patient's abilities
Anesthesia/Sedation: Not applicable
Duration
Typical Duration: Customization and training can take several hours, whereas fitting and adjustments may be spread over multiple sessions.
Setting
Location:
- Outpatient clinics specializing in mobility aids
- Hospitals with rehabilitation facilities
- Specialized wheelchair and seating centers
Personnel
Healthcare Professionals Involved:
- Physical therapists or occupational therapists specializing in seating and mobility
- Rehabilitation engineers
- Medical suppliers of durable medical equipment
Risks and Complications
Common Risks:
- Mechanical failure or malfunction of power components
- Skin irritation from contact points
Rare Risks:
- Worsening of existing pressure sores if improperly fitted
- Electrical issues or battery failures
Management of Complications:
- Regular maintenance checks and adjustments
- Immediate consultation with a specialist for mechanical issues
Benefits
Expected Benefits:
- Increased comfort and prevention of pressure sores
- Greater independence in daily activities
- Improved physical alignment and reduction of pain
Realization Timeframe: Benefits can often be seen immediately but may improve over weeks to months as the patient adjusts.
Recovery
Post-Procedure Care:
- Regular follow-up appointments for adjustments
- Routine inspection and maintenance of the wheelchair
- Adherence to proper use guidelines provided during training
Expected Recovery Time: Adaptation to the system typically occurs within a few weeks.
Restrictions/Follow-up Appointments:
- Periodic reviews to ensure continued proper fit and function
- No specific activity restrictions, although initial adaptation advice may be provided
Alternatives
Other Treatment Options:
- Manual wheelchairs with tilt or recline functions
- Standard electric wheelchairs without advanced seating systems
- Adaptive seating solutions with position adjustments
Pros and Cons of Alternatives:
- Manual Wheelchairs: Less expensive, no power requirement but require significant user or caregiver effort.
- Standard Electric Wheelchairs: Easier to use but lack advanced positioning benefits.
- Adaptive Seating Solutions: Can be tailored but may not offer comprehensive tilt and recline options.
Patient Experience
What to Expect During and After:
- During fitting sessions: adjustment procedures with minor discomfort
- After fitting: improved comfort and mobility
- Pain Management: Generally not needed; discomfort addressed by adjusting the system
Comfort Measures:
- Cushions and padding tailored to patient needs
- Easy-to-use controls designed for minimal effort