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Upper limb orthosis, not otherwise specified

HCPCS code

Name of the Procedure:

Common Name(s): Custom Upper Limb Brace
Technical/Medical Term(s): Upper Limb Orthosis, Not Otherwise Specified (HCPCS Code: L3999)

Summary

An upper limb orthosis is a custom-made brace designed to support, align, prevent, or correct deformities or to improve the function of the arm. It can help stabilize the elbow, wrist, or hand following an injury or surgery.

Purpose

The primary goal of an upper limb orthosis is to restore or improve arm function, reduce pain, and enhance healing. It is used to treat various medical conditions like fractures, joint instability, tendon injuries, or nerve damage. The orthosis helps in immobilizing the limb, providing support during the healing process, or aiding in functional rehabilitation.

Indications

  • Fractures or breaks in the bones of the arm
  • Joint instability due to ligament injuries
  • Tendon or muscle damage
  • Nerve injuries or conditions like carpal tunnel syndrome
  • Post-operative support following surgery on the arm or hand

Preparation

  • Pre-Procedure Instructions: Typically, no special preparations are needed.
  • Diagnostic Tests: X-rays, MRI, or other imaging techniques may be required to determine the appropriate type of orthosis.

Procedure Description

  1. Consultation: Patient meets with an orthotist or orthopedic specialist to assess the limb and discuss needs.
  2. Custom Fitting: Measurements and/or molds of the limb are taken.
  3. Orthosis Fabrication: The brace is custom-made, usually involving materials like plastic, metal, or composites.
  4. Fitting and Adjustment: The patient tries on the brace to ensure a proper fit. Adjustments are made for comfort and functionality.
  5. Instructions: Patient is instructed on how to use, wear, and maintain the orthosis.

Tools/Equipment:

  • Measuring tools
  • Casting materials (if making a mold)
  • Orthosis materials (plastic, metal, composites)

Anesthesia or Sedation: Not applicable.

Duration

The fitting session typically lasts 30 minutes to an hour. It may take a few days to weeks to fabricate the orthosis.

Setting

Orthotic and prosthetic clinics, orthopedic surgeons' offices, or rehabilitation centers.

Personnel

Orthotist, orthopedic specialist, occasionally a physical therapist for functional training.

Risks and Complications

Common Risks:

  • Minor skin irritation
  • Discomfort or improper fit initially

Rare Complications:

  • Pressure sores
  • Allergic reaction to materials
  • Limitation of movement if not properly fitted

Management includes adjustments to the orthosis or changing materials.

Benefits

  • Improved arm function and stability
  • Reduced pain
  • Enhanced healing and recovery
  • Potential to avoid surgical interventions

Benefits are typically realized within days to weeks, depending on the condition being treated.

Recovery

  • Post-Procedure Care: Keep the brace clean and dry. Follow the usage instructions provided.
  • Expected Recovery Time: Varies based on underlying condition; generally, weeks to months.
  • Restrictions: Limit activities that could compromise the healing process.
  • Follow-Up Appointments: Periodic adjustments and assessments may be needed.

Alternatives

  • Conservative Treatment: Physical therapy, pain relief medications, or temporary splints.
  • Surgical Options: Depending on the condition, surgical fixation or repair might be considered.

Pros and Cons:

  • Orthosis Pros: Non-invasive, customizable, and relatively low-risk.
  • Orthosis Cons: May require time to adapt, minor discomfort.
  • Surgical Pros: Definitive correction.
  • Surgical Cons: Higher risks, longer recovery.

Patient Experience

  • During Procedure: Little to no discomfort.
  • After Procedure: May experience mild discomfort or adjustment period. Pain management is usually minimal. Comfort improves as the patient adapts to wearing the orthosis.

Medical Policies and Guidelines for Upper limb orthosis, not otherwise specified

Related policies from health plans

Orthotics
Orthotics

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