Name of the Procedure:

Positioning Wheelchair Back Cushion, Posterior, Width 22 inches or Greater, Any Height, Including Any Type Mounting Hardware (HCPCS E2614).

Summary

The procedure involves fitting a specialized back cushion onto a wheelchair to enhance posture and comfort for individuals with mobility impairments. This particular cushion is designed for wheelchairs with backs that are 22 inches wide or greater and can include various types of mounting hardware for secure attachment.

Purpose

The cushion aims to:

• Improve posture and spinal alignment.
• Enhance comfort and reduce pressure sores.
• Support the back for individuals with limited mobility.

Indications

• Chronic back pain due to poor posture.
• Spinal deformities or weakness.
• Pressure sores or risk thereof.
• General discomfort in a standard wheelchair.

Patients with the following conditions may benefit:

• Spinal cord injuries.
• Muscular dystrophy.
• Multiple sclerosis.
• Elderly patients with weakened postural control.

Preparation

• No special preparation like fasting is required.
• The patient's wheelchair should be evaluated to ensure compatibility with the cushion.
• Assessment of the patient's physical condition to determine the optimal cushion type and fit.

Procedure Description

1. Initial Assessment: Conducted by an occupational therapist or healthcare provider to determine the patient's needs.
2. Selection and Customization: Choosing a cushion of appropriate width (22 inches or greater) and height, with the necessary mounting hardware.
3. Installation: Attaching the cushion to the wheelchair securely, making adjustments as required for optimal fit and comfort.
4. Final Check: Ensuring that the cushion is positioned correctly and is stable.

Tools and Equipment:

• Specialized back cushion.
• Mounting hardware (which may include brackets, screws, and straps).
• Basic hand tools for installation.

No anesthesia or sedation is required.

Duration

The fitting and installation process typically take about 30 minutes to one hour.

Setting

The procedure is usually performed in:

• A rehabilitation center.
• An outpatient clinic.
• At home, if conducted by a visiting occupational therapist.

Personnel

• Occupational therapist or physiotherapist.
• Possibly a rehabilitation specialist familiar with wheelchair modifications.

Risks and Complications

• Minimal risks, mostly revolving around improper installation which might lead to discomfort or inadequate support.
• Rarely, improper fit can cause skin irritation or exacerbate pressure sores.

Benefits

• Improved posture and back support.
• Enhanced comfort during prolonged wheelchair use.
• Potential reduction in back pain and pressure sores. Expected benefits can often be realized immediately after installation.

Recovery

• No recovery time is needed as this is a non-invasive procedure.
• Initial period of adjustment for the patient to get used to the new cushion.
• Follow-up appointments may be scheduled to reassess fit and comfort.

Alternatives

• Standard wheelchair cushions, which may offer less support.
• Custom-made wheelchair backs, which might provide more extended support but at a higher cost.
• Various orthopedic back supports or braces.

Patient Experience

During the procedure:

• The patient may need to sit in different positions while adjustments are made.
• The experience is typically painless and involves minimal physical stress.

After the procedure:

• The patient may feel an immediate improvement in comfort.
• Some initial soreness is possible as the body adjusts to the new positioning. Pain management:
• Generally unnecessary except for minor discomfort that can be managed with over-the-counter pain relief if needed.