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Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

HCPCS code

Name of the Procedure:

Shoulder Orthosis Fitting and Adjustment
Common Name(s): Shoulder Brace Fitting
Technical Term: Shoulder Orthosis, Shoulder Joint Design, Custom Fabricated (HCPCS Code: L3671)

Summary

A shoulder orthosis fitting and adjustment is a non-invasive procedure where a custom-made shoulder brace is designed, fitted, and adjusted to provide support and stability to the shoulder joint. This is done without the use of mechanical joints in the orthosis itself, but may include soft interfaces and straps.

Purpose

The main goal of this procedure is to provide support and immobilization to the shoulder region to enhance healing and reduce pain. It addresses conditions such as shoulder dislocations, rotator cuff injuries, fractures, and other musculoskeletal issues. The expected outcome is to improve shoulder stability and function during the healing process.

Indications

  • Shoulder dislocation or subluxation
  • Rotator cuff injuries or tears
  • Shoulder fractures
  • Glenohumeral instability
  • Post-operative shoulder support
  • Patients with chronic shoulder pain or arthritis affecting the shoulder joint

Preparation

  • No specific pre-procedure instructions such as fasting are required.
  • A physical examination and possibly imaging studies (e.g., X-ray, MRI) might be needed to assess the condition of the shoulder before fitting the orthosis.

Procedure Description

  1. Assessment: A healthcare professional examines the shoulder to determine the specific requirements for the orthosis.
  2. Measurements: Detailed measurements of the shoulder and surrounding areas are taken to customize the orthosis.
  3. Fabrication: The orthosis is custom-made based on the measurements and specific needs of the patient.
  4. Fitting: The patient tries on the orthosis, and adjustments are made to ensure a proper fit.
  5. Instruction: The patient is instructed on how to wear, adjust, and care for the orthosis.

Tools Used:

  • Measuring tape
  • Fitting tools
  • Custom fabrication materials

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

Duration

The fitting and adjustment procedure typically takes about 1 to 2 hours.

Setting

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

Personnel

  • Orthopedic specialist
  • Orthotist (a healthcare professional specialized in orthotic devices)
  • Possibly a physical therapist

Risks and Complications

  • Skin irritation or pressure sores
  • Discomfort or improper fit
  • Allergic reactions to materials

These risks are generally minor and can be managed with proper follow-up and adjustments.

Benefits

  • Improved shoulder stability and function
  • Pain reduction
  • Enhanced healing process
  • Better support for daily activities

The benefits can typically be realized immediately after the orthosis is properly fitted and adjusted.

Recovery

  • Wear the orthosis as instructed by the healthcare provider.
  • Regular follow-up appointments to monitor and adjust the orthosis.
  • May involve physical therapy to complement the use of the orthosis.
  • Recovery time varies depending on the underlying condition but consistent use of the orthosis can expedite the healing process.

Alternatives

  • Physical therapy alone
  • Over-the-counter braces or supports
  • Surgical intervention for severe cases
  • Pain management medications

Pros and cons of alternatives:

  • Physical therapy alone may not provide enough support.
  • Over-the-counter braces may not offer the custom support needed.
  • Surgery involves more risks and a longer recovery time.
  • Medications do not provide structural support to the shoulder.

Patient Experience

During the procedure, the patient may experience some discomfort while various measurements are taken and during the initial fitting. Post-procedure, the patient should feel an immediate improvement in shoulder stability. Minor adjustments may be needed over time to ensure ongoing comfort and effectiveness. Pain management typically involves over-the-counter pain relievers if needed, and the patient may experience overall increased comfort and mobility relatively quickly after the fitting.

Medical Policies and Guidelines for Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

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