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Name of the Procedure:
Common Name: Pediatric Rigid Wheelchair with Adjustable Seating System
Technical/Medical Term: Wheelchair, pediatric size, rigid, adjustable, with seating system (HCPCS Code: E1235)
Summary
A pediatric rigid wheelchair with an adjustable seating system is a specialized mobility device designed for children. It provides support and mobility for children who have difficulty walking or cannot walk at all. The “rigid” means it has a solid frame that doesn’t fold, while “adjustable” indicates that the seat, leg rests, and other components can be customized to fit the child’s needs.
Purpose
Medical Conditions Addressed:
- Cerebral Palsy
- Muscular Dystrophy
- Spina Bifida
- Severe injury or trauma affecting mobility
Goals/Expected Outcomes:
- Enhance mobility and independence
- Provide adequate postural support
- Prevent complications such as pressure sores
- Facilitate participation in daily activities and social interaction
Indications
Symptoms/Conditions:
- Children with significant mobility impairment
- Lack of trunk control or postural stability
- Requirements for specific seating adjustments due to deformities or growth
Patient Criteria:
- Pediatric patients requiring long-term wheelchair use
- Individuals with customizable seating needs due to their unique physical condition
Preparation
Pre-procedure Instructions:
- Obtain measurements for custom adjustments
- Bring any current mobility devices or aids for comparison
Diagnostic Tests/Assessments:
- Physical and Occupational Therapy evaluation
- Posture and seating assessment
- Medical history and mobility assessment
Procedure Description
Step-by-Step Explanation:
- Measurement: Custom measurements are taken of the child's body.
- Custom Build: The wheelchair is constructed based on these measurements with an adjustable seating system.
- Fitting: The child is fitted into the wheelchair, making necessary adjustments for comfort and functionality.
- Education: Instructions are provided to caregivers on how to adjust and use the wheelchair.
Tools, Equipment, Technology:
- Measuring tools (tape measure, angle gauges)
- Adjustable pediatric rigid wheelchair frame
- Custom seating system components
Anesthesia/Sedation:
- Not applicable
Duration
- Fitting and adjustment typically take 1-2 hours over one or more sessions.
Setting
- Outpatient clinic or specialized wheelchair service center
Personnel
- Physical Therapist
- Occupational Therapist
- Assistive Technology Professional (ATP)
- Medical Equipment Supplier
Risks and Complications
Common Risks:
- Initial discomfort
- Improper fit leading to postural issues
Rare Risks:
- Development of pressure sores
- Skin irritation from materials
Management of Complications:
- Regular follow-up for adjustments
- Immediate reporting of discomfort or skin issues
Benefits
- Improved mobility and independence
- Enhanced comfort and fit
- Prevention of pressure sores and other complications
- Better participation in daily and social activities
Recovery
Post-procedure Care:
- Regular monitoring and adjustments
- Training for child and caregivers on proper use
Recovery Time:
- Immediate use but may take a few days to weeks to fully adapt
- Follow-up appointments for adjustments
Alternatives
Other Options:
- Folding manual wheelchairs
- Power wheelchairs
- Strollers for children with special needs
Pros and Cons:
- Folding wheelchairs: More portable but less stable
- Power wheelchairs: Easier mobility but more expensive and less durable for children
- Strollers: More lightweight but less supportive and customizable
Patient Experience
During Procedure:
- Expected to sit for measurements and adjustments
- May experience mild discomfort during fitting
After Procedure:
- Increased mobility and comfort
- May require some adaptation period to new seating
- Pain management not typically necessary beyond minor adjustments for comfort
Medical Policies and Guidelines
Related policies from health plans
E1235 policy automation walkthrough
Walk through the policies, prior authorization requirements, and workflow automation opportunities connected to this code.