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Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment

HCPCS code

Name of the Procedure:

Knee Ankle Foot Orthosis (KAFO), Full Plastic, Static (Pediatric Size), Without Free Motion Ankle, Prefabricated, Includes Fitting and Adjustment (HCPCS Code L2035)

Summary

This procedure involves fitting a child with a prefabricated knee-ankle-foot orthosis (KAFO). The KAFO is a brace that stabilizes the knee, ankle, and foot, crafted from durable plastic and without any free movement at the ankle joint. The brace provides support and alignment for lower limb impairments.

Purpose

The procedure aims to address medical conditions that necessitate stabilization and alignment of the lower limb, such as muscle weakness, joint instability, or deformities. The goal is to enhance mobility, improve function, and prevent further complications by providing necessary support.

Indications

  • Muscle weakness
  • Joint instability
  • Limb deformities due to conditions like cerebral palsy, spina bifida, or muscular dystrophy
  • Post-operative protection and stabilization

The procedure is appropriate for pediatric patients who demonstrate these symptoms and require external support for proper limb alignment.

Preparation

Patients typically do not need to undertake any special preparation such as fasting or medication adjustments. However, a thorough physical examination and assessment of the child's lower limb, including measuring to ensure proper fit of the orthosis, are essential.

Procedure Description

  1. Assessment: The healthcare provider examines the patient’s lower limb to determine the need for a KAFO and to ensure proper measurements.
  2. Selection: A prefabricated KAFO of the appropriate size is chosen.
  3. Fitting: The orthosis is placed on the child's leg to ensure a snug, comfortable fit.
  4. Adjustment: Minor adjustments are made to the KAFO to tailor it to the patient's needs.
  5. Instruction: The caregiver and patient receive guidance on how to wear the orthosis, care for it, and when it should be used.

No anesthesia or sedation is required for this non-invasive procedure.

Duration

The fitting and adjustment process typically takes about 30 minutes to 1 hour.

Setting

This procedure is usually performed in an outpatient clinic, orthopedic practice, or a specialized orthotics and prosthetics facility.

Personnel

The procedure is conducted by an orthotist, a healthcare professional specializing in orthopedic devices, sometimes in conjunction with a physical therapist.

Risks and Complications

  • Skin irritation or pressure sores
  • Discomfort or pain due to improper fit
  • Allergic reactions to the material
  • The device may need adjustments or replacements as the child grows

Complications are generally manageable with proper care and adjustments.

Benefits

  • Enhanced stability and alignment
  • Improved mobility and functionality
  • Prevention of further limb deformities
  • Better overall quality of life

Improvements can be noticed immediately, though some benefits may take a few weeks as the patient adapts to the orthosis.

Recovery

No specific recovery period is required. Patients and caregivers should follow instructions on wearing and caring for the orthosis. Regular follow-up appointments may be necessary to monitor progress and make adjustments.

Alternatives

  • Lower limb orthoses with free motion at the ankle
  • Custom-made KAFOs for a more personalized fit
  • Physical therapy and exercises alone

Each alternative option comes with its pros and cons in terms of comfort, cost, and effectiveness. Custom KAFOs are often more expensive but provide a more individualized fit.

Patient Experience

The patient might experience some initial discomfort as they get used to the KAFO. Pain management typically includes over-the-counter pain relievers if needed. Continuous monitoring and intermittent adjustments ensure the patient's comfort and the effectiveness of the orthosis.

Medical Policies and Guidelines for Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment

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