Medical HCPCS Procedure Description

Name of the Procedure:

Addition to Lower Extremity Prosthesis - Endoskeletal Knee-Shin System with Microprocessor Control Feature, Swing and Stance Phase, Includes Electronic Sensor(s) (L5856)

Summary

This procedure involves adding a sophisticated endoskeletal knee-shin system to a lower extremity prosthesis. The system uses a microprocessor and electronic sensors to help control the swing and stance phases of walking, allowing for smoother, more natural movement.

Purpose

The procedure is designed for individuals who require improved functionality and stability in their lower extremity prosthesis. The microprocessor control helps in better managing walking dynamics, reducing the risk of falls, and enhancing overall mobility.

Indications

• Individuals with lower limb amputations who require a prosthesis
• Patients experiencing difficulty with stability or movement using a conventional prosthesis
• Candidates needing improved control over dynamic walking phases (swing and stance)

Preparation

• Patients may need to undergo a comprehensive assessment, including gait analysis
• Adjustments to current medications or fasting instructions are typically not required
• Preliminary fitting or measurements of the prosthetic limb

Procedure Description

1. Assessment: A detailed gait analysis and fitting session with the prosthetist.
2. Customization: Tailoring the knee-shin system to the patient’s specific needs.
3. Attachment: The microprocessor-controlled knee-shin system is integrated into the existing lower extremity prosthesis.
4. Calibration: The system is calibrated using electronic sensors to ensure optimal functionality.
5. Training: Patients are given instructions and initial training on using the new system.

• Tools and Equipment: Endoskeletal knee-shin system, microprocessor control unit, electronic sensors
• Anesthesia: Typically, no anesthesia is required as this is a non-invasive adjustment procedure.

Duration

The entire procedure, including assessment, customization, and calibration, usually takes about 2-3 hours.

Setting

The procedure is typically performed at a specialized prosthetics clinic or outpatient facility.

Personnel

• Prosthetists
• Physical therapists
• Technicians

Risks and Complications

• Device malfunction or failure
• Skin irritation or discomfort at the points of attachment
• Learning curve and potential initial difficulty in adapting to the new system

Benefits

• Enhanced stability and balance
• Improved control over walking dynamics, reducing the risk of trips and falls
• Increased comfort and a more natural gait pattern
• Benefits typically realized within a few days to a couple of weeks post-fitting

Recovery

• Follow-up appointments for adjustments and monitoring
• Rehabilitation sessions with a physical therapist may be recommended
• Most patients can resume normal activities shortly after the fitting, with improved gait and mobility as they adapt to the new system

Alternatives

• Conventional mechanical knee-shin systems without microprocessor control
• Hydraulic or pneumatic knee systems
• Each alternative varies in terms of cost, functionality, and suitability for the patient’s lifestyle

Patient Experience

• Minimal discomfort during the fitting process
• Initial period of adaptation to the new mechanics
• Physical therapy sessions can facilitate smoother transition and better outcomes
• Pain management generally not required, but any discomfort is typically minor and temporary

This enhanced prosthetic system offers a significant improvement in quality of life for individuals requiring lower limb prostheses, making day-to-day activities easier and reducing the likelihood of falls and other complications associated with less advanced prosthetic solutions.