Name of the Procedure:

Power Wheelchair Accessory Upgrade: Expandable Controller
(HCPCS Procedure E2377)

Summary

This procedure involves upgrading a power wheelchair with an expandable controller, including all the related electronics and mounting hardware. It is typically provided at the initial issue of the wheelchair to enhance its control and functionality.

Purpose

Medical Conditions or Problems Addressed:

• Mobility impairment due to conditions such as muscular dystrophy, multiple sclerosis, spinal cord injuries, or severe arthritis.

Goals or Expected Outcomes:

• Improved maneuverability and independence for individuals who rely on power wheelchairs.
• Enhanced customization to meet specific user needs.
• Facilitated operation of additional powered accessories.

Indications

Symptoms or Conditions:

• Difficulty in controlling standard wheelchair controls.
• Increasingly complex mobility needs.
• Requirement for advanced technological solutions to manage severe mobility issues.

Patient Criteria:

• Patients assessed by a healthcare provider to benefit from specialized wheelchair controls.
• Individuals who demonstrate significant functional limitations and need for customization.

Preparation

Pre-procedure Instructions:

• Ensure the patient's power wheelchair is evaluated by a healthcare professional.
• Discuss any specific needs or preferences regarding control mechanisms with the supplier and healthcare team.
• No specific fasting or medication adjustments are typically necessary.

Diagnostic Tests or Assessments:

• Functional mobility assessment by a physical therapist or mobility specialist.
• Review of the patient's medical history and current condition.

Procedure Description

Step-by-Step Explanation:

1. Assessment & Measurement: A thorough assessment to determine the best type of expandable controller and necessary adjustments.
2. Selection: Choose the expandable controller and related electronics.
3. Mounting Hardware Installation: Install the required mounting hardware on the wheelchair to accommodate the new controller.
4. Controller Installation: Attach the expandable controller to the wheelchair.
5. Wiring & Electronics: Connect all related electronics to ensure proper functioning of the controller.
6. Calibration and Testing: Calibrate the controller settings and conduct a series of tests to ensure everything works correctly.
7. Training: Provide the user with training on how to use the new controller.

Tools, Equipment, or Technology Used:

• Expandable controller unit.
• Electronic wiring and connectors.
• Mounting brackets and hardware.
• Calibration devices.

Anesthesia or Sedation:

• Not applicable.

Duration

The entire process typically takes a few hours, including installation, testing, and training.

Setting

The procedure can be performed at a specialized medical equipment provider's location, an outpatient clinic, or at the patient's home if the provider offers such services.

Personnel

• Mobility specialist or technician.
• Physical therapist (if needed for assessment and training).
• Supplier representative.

Risks and Complications

Common Risks:

• Minor issues with initial controller sensitivity or calibration.
• Temporary confusion or difficulty adjusting to the new controls.

Possible Complications:

• Electrical malfunctions if not properly installed.
• Discomfort or poor ergonomics if the mounting hardware is incorrectly positioned.

Management:

• Regular follow-ups and adjustments by the provider.
• Immediate troubleshooting and support services.

Benefits

Expected Benefits:

• Enhanced control and independence.
• Customizable features tailored to the patient's needs.
• Ability to operate additional powered accessories.

Realization Timeline:

• Immediate improvement in wheelchair functionality; full adaptation may take a few days to weeks.

Recovery

Post-procedure Care and Instructions:

• Regular use and practice to adapt to the new controller.
• Follow-up visits for any necessary adjustments.

Expected Recovery Time:

• Minimal; users can typically start using the upgraded wheelchair immediately.

Restrictions or Follow-up Appointments:

• Scheduled follow-up appointments to ensure everything is functioning correctly.

Alternatives

Other Treatment Options:

• Standard joystick controls.
• Alternative power wheelchair models with different control systems.

Pros and Cons:

• Standard Joystick Controls: Easier to use for some; less customizable.
• Alternative Models: May not offer the same level of customization; potentially higher cost and longer installation time.

Patient Experience

During the Procedure:

• Minimal discomfort; most of the work is done on the wheelchair itself.
• Interaction with the team for adjustments and training.

After the Procedure:

• Gradual adaptation to the new controller.
• Possible initial challenges, but overall enhanced mobility and independence.
• Continuous support and adjustments to ensure comfort and usability.