Name of the Procedure:

Back, Contoured, for Pediatric Size Wheelchair Including Fixed Attaching Hardware (HCPCS Code: E2293)

Summary

The installation of a contoured back support for a pediatric wheelchair involves fitting the wheelchair with a supportive backrest that conforms to the child's spine and body shape. This procedure includes the necessary fixed hardware to securely attach the backrest to the wheelchair frame.

Purpose

The purpose of this procedure is to provide enhanced support and comfort for children who use wheelchairs due to various medical conditions. The contoured back helps to improve posture, prevent deformities, and enhance the overall functionality and comfort of the wheelchair.

Indications

• Poor posture or spinal deformities in wheelchair-bound pediatric patients.
• Muscular dystrophy, cerebral palsy, or other conditions affecting muscle control and spinal stability.
• Need for improved seating support to prevent pressure sores or discomfort.

Preparation

• No specific fasting or medication adjustments required.
• An assessment by a physical therapist or rehabilitation specialist to determine the proper fit and contouring needs.
• Measurements of the child's torso and back to ensure a custom fit.

Procedure Description

1. Assessment: The therapist reviews the child’s medical history and conducts a physical examination to understand their postural requirements.
2. Customization: The contoured backrest is customized based on the child's spinal structure and needs.
3. Installation: Professionals attach the contoured backrest to the pediatric wheelchair using fixed attaching hardware.
4. Adjustment: The fit is checked and adjustments made for optimal support and comfort.

Duration

The procedure typically takes about 1-2 hours, including assessment and installation.

Setting

The procedure is usually performed in an orthopedic or rehabilitation clinic.

Personnel

• Physical or occupational therapist
• Rehabilitation specialist
• Orthopedic technician

Risks and Complications

• Minor risks of discomfort during the initial fitting.
• Potential for skin irritation or pressure sores if not properly adjusted.
• Rare possibility of hardware malfunction or loosening over time.

Benefits

• Improved posture and spinal alignment.
• Enhanced comfort and reduced risk of pressure sores.
• Increased mobility and functionality using the wheelchair.
• Benefits are typically realized immediately after installation, with ongoing adjustments as needed.

Recovery

• Regular follow-up appointments to ensure the contoured backrest continues to provide proper support as the child grows.
• No specific recovery period; some adjustments may be needed based on the child’s feedback and growth.

Alternatives

• Standard wheelchair backrests, which may not provide as much support or comfort.
• Custom molded seating systems, which can be more expensive and complex to install.

Patient Experience

• During the installation, children may need to sit in their wheelchair for an extended period, which could cause mild discomfort.
• Post-procedure, children should experience enhanced comfort and support.
• Pain management is not usually required, although comfort measures include ensuring proper padding and skin checks.