Wheelchair with Fixed Arm, Elevating Legrests (E1222)

Name of the Procedure:

• Common Name: Wheelchair with fixed arm, elevating legrests
• Technical/Medical Term: Wheelchair, fixed arm, elevating legrests, manual (HCPCS code E1222)

Summary

A wheelchair with fixed arms and elevating legrests is a type of manual wheelchair designed to provide mobility assistance, particularly for individuals with mobility impairments. The fixed arms offer a stable armrest, while the elevating legrests can be adjusted to improve comfort and circulation.

Purpose

• Medical Conditions Addressed: Mobility impairments due to spinal cord injuries, muscle weakness, arthritis, or other conditions causing restricted movement.
• Goals/Outcomes: Improve mobility, enhance independence, prevent pressure sores and enhance overall comfort for individuals with limited mobility.

Indications

• Symptoms/Conditions: Inability to walk or restricted walking capacity, need for prolonged sitting with improved lower limb positioning.
• Patient Criteria: Suitable for individuals who have sufficient upper body strength to propel a manual wheelchair but require support for their legs to prevent discomfort or complications.

Preparation

• Pre-Procedure Instructions: No specific pre-procedure instructions are typically required, but an assessment by a healthcare professional to determine the appropriateness and fit of the wheelchair.
• Assessments: Physical and occupational therapy evaluation to ensure proper fit, comfort, and functionality.

Procedure Description

1. Assessment: A healthcare professional assesses the patient’s needs and fits them for the wheelchair.
2. Selection: The appropriate wheelchair is selected based on the patient’s size, strength, and specific requirements (fixed arms and elevating legrests).
3. Customization: Adjustments are made to the wheelchair to ensure optimal comfort, including setting the legrests at the correct angle.
4. Instruction: The patient and caregivers are given detailed instructions on how to use and maintain the wheelchair.

Tools, Equipment, and Technology

• Manual wheelchair with fixed arms and elevating legrests
• Tools for adjustment and customization

Anesthesia or Sedation

• Not applicable

Duration

• Time for fitting and adjustment: Approximately 1-2 hours

Setting

• Location: Rehabilitation center, outpatient clinic, or home environment

Personnel

• Healthcare Professionals Involved: Physical therapist, occupational therapist, and potentially a medical equipment specialist

Risks and Complications

• Common Risks: Skin irritation or pressure sores due to incorrect fit or prolonged use, mechanical failures.
• Rare Risks: Circulatory issues if legrests are not properly adjusted.
• Management: Regular monitoring and adjustments, use of pressure-relief cushions.

Benefits

• Expected Benefits: Enhanced mobility, increased independence, improved comfort, prevention of pressure sores.
• Time to Realization: Immediate improvement in mobility and comfort upon proper fitting.

Recovery

• Post-Procedure Care: Regular maintenance of the wheelchair, periodic reassessment for fit and function.
• Recovery Time: None - immediate use post-fitting.
• Restrictions/Follow-Up Appointments: Routine follow-ups with healthcare providers for adjustments and to address issues.

Alternatives

• Other Treatment Options: Motorized wheelchair, scooters, using walking aids such as canes or walkers.
• Pros and Cons:
  • Alt 1: Motorized Wheelchair: Easier for users with severe upper body weakness, more expensive, requires charging.
  • Alt 2: Scooters: Suitable for outdoor use, limited indoor maneuverability.
  • Alt 3: Walking Aids: Less costly, useful for those with partial mobility, not suitable for those unable to walk.

Patient Experience

• During the Procedure: The patient will experience being assessed and possibly seated in different chairs for fitting.
• After the Procedure: The patient may take some time adjusting to the wheelchair, learning to use it effectively. Regular use should lead to improved comfort and mobility.
• Pain Management and Comfort Measures: Custom fit and proper adjustments ensure comfort, and patient education on use and maintenance reduce the risk of discomfort.