Name of the Procedure:

Orthopedic Shoe Modification or Addition (HCPCS Code: L3649)
Common Name(s): Custom Orthopedic Shoe Modification
Technical or Medical Term(s): Orthopedic Shoe, Modification, Addition, or Transfer, Not Otherwise Specified

Summary

This procedure involves altering an orthopedic shoe to better accommodate a patient's specific foot conditions. It may include adding custom inserts, modifying the shoe structure, or transferring modifications from another shoe.

Purpose

Medical Conditions:

• Foot deformities
• Arthritis
• Diabetes-related foot issues
• Abnormal gait ##### Goals:
• Improve foot comfort and function
• Alleviate pain
• Enhance mobility
• Prevent or manage foot ulcers and other related complications

Indications

Symptoms:

• Chronic foot pain
• Difficulty walking
• Uneven shoe wear ##### Conditions:
• Plantar fasciitis
• Bunions
• Hammer toes
• Diabetic neuropathy ##### Patient Criteria:
• Individuals who have not responded to standard footwear
• Those needing personalized foot support

Preparation

Pre-procedure Instructions:

• Wear comfortable clothes
• Bring current orthopedic shoes, if any ##### Diagnostic Tests:
• Foot measurements
• Gait analysis

Procedure Description

Steps:

1. Initial assessment by a podiatrist or orthopedic specialist.
2. Detailed foot measurements and analysis.
3. Designing the custom modification or addition.
4. Altering the shoe using specialized tools.
5. Final fitting and adjustments. ##### Tools:
   • Shoe modification equipment (e.g., grinders, stretchers)
   • Custom orthotic material ##### Anesthesia:
   • Typically none; local anesthesia if invasive procedures needed

Duration

• 30 minutes to 2 hours, depending on complexity

Setting

• Outpatient clinic or specialized orthopedic facility

Personnel

• Podiatrist or Orthopedic Specialist
• Orthopedic Technician

Risks and Complications

Common Risks:

• Minor discomfort ##### Rare Risks:
• Infections (if invasive modifications are made)
• Allergic reactions to materials ##### Management:
• Follow-up consultations to adjust or address complications

Benefits

• Improved comfort and mobility
• Reduced pain
• Customized fit for prevention of further foot issues ##### Timeframe:
• Immediate to a few days post-modification

Recovery

Post-procedure Care:

• Gradual break-in period for the modified shoe
• Monitoring for any discomfort or issues ##### Recovery Time:
• Typically immediate ##### Restrictions:
• None, generally ##### Follow-up:
• Routine checks to ensure the modification's effectiveness

Alternatives

Options:

• Off-the-shelf orthopedic shoes
• Physical therapy
• Medication for pain management ##### Pros and Cons:
• Alternatives may be less personalized but more affordable and readily available

Patient Experience

During the Procedure:

• Minimal discomfort ##### After the Procedure:
• Enhanced comfort while walking
• Possible initial adjustment period ##### Pain Management:
• Generally not needed, over-the-counter options if required