Name of the Procedure:

Custom Motorized/Power Wheelchair Base (HCPCS K0013)

Summary

A custom motorized/power wheelchair base provides mobility assistance for individuals significantly impaired in their ability to walk. This customized wheelchair base is designed to meet the unique needs of each patient, enhancing their independence and quality of life.

Purpose

A custom motorized/power wheelchair base is used to:

• Provide mobility for individuals unable to walk or with severe gait instability.
• Increase independence and improve daily life activities.
• Minimize the risk of secondary complications like pressure sores and cardiovascular issues from prolonged immobility.

Indications

• Severe mobility impairment due to conditions like multiple sclerosis (MS), cerebral palsy, spinal cord injuries, or advanced arthritis.
• Patients who cannot effectively use a manual wheelchair due to arm or muscle weakness.
• Severe gait instability causing frequent falls.

Preparation

• Assessment by a mobility specialist and/or occupational therapist to determine specific needs.
• Measurement for custom fitting to ensure proper posture and comfort.
• Evaluation of the home environment to ensure accessibility and safety.

Procedure Description

1. Assessment and Customization: The patient undergoes a thorough assessment to determine their specific mobility needs.
2. Specification and Ordering: A prescription is written by a healthcare provider, specifying the required custom features.
3. Manufacturing: The custom wheelchair base is manufactured according to the specifications.
4. Fitting and Adjustments: The wheelchair is fitted to the patient, with adjustments made for comfort and functionality.
5. Training: The patient and caregivers receive training on the use and maintenance of the wheelchair.

Duration

The initial assessment and fitting process may take a few hours, while the manufacturing can take several weeks.

Setting

The assessment and fitting are typically performed in a specialized clinic or outpatient setting, but the use and maintenance occur in the patient's daily environment.

Personnel

• Occupational Therapist or Physical Therapist
• Mobility Specialist
• Healthcare Provider (e.g., Primary Care Physician or Specialist)
• Manufacturer's Technician

Risks and Complications

• Potential pressure sores if the fit is not correct.
• Mechanical failure or issues with the motorized system.
• User safety concerns for navigating certain terrains.

Benefits

• Increased independence and ability to perform daily activities.
• Improved quality of life and social participation.
• Reduced risk of secondary health issues from prolonged immobility.

Recovery

There is no traditional recovery period as it is not a surgical procedure. However, adjustments and adaptations may be needed as the patient adapts to the new equipment. Follow-up appointments may be necessary to ensure optimal use and comfort.

Alternatives

• Manual wheelchairs: Less expensive but require upper body strength.
• Scooters: Suitable for some users but lack custom features.
• Non-motorized custom wheelchairs: For users who can propel themselves.

Pros and Cons:

• Manual Wheelchairs: More affordable, no need for power sources, but physically demanding.
• Scooters: Less customizable, not ideal for significant postural needs.

Patient Experience

• During: There is no invasive procedure; the patient undergoes assessments and fittings.
• After: Patients may experience increased independence but may require time to adapt to new mobility technology. Pain management is generally not necessary, but comfort measures include proper cushion support and regular adjustments.