Name of the Procedure:

HCPCS Procedure Code L6620: Upper Extremity Addition, Flexion/Extension Wrist Unit, With or Without Friction

Summary

The procedure involves the addition of a flexion/extension unit to a prosthetic upper limb. This piece allows for better wrist movement, imitating natural flexion and extension, and can be adjusted to provide friction or operate freely, depending on the patient's needs.

Purpose

The procedure aims to improve the mobility and functionality of a prosthetic upper extremity, specifically the wrist joint. It helps individuals who have lost their wrist function due to amputation, providing them with better ease-of-use and control over their prosthetic limb.

Indications

• Patients with upper extremity amputations requiring a prosthesis.
• Individuals experiencing difficulty or discomfort with a rigid wrist unit.
• Patients seeking increased flexibility and movement in their prosthetic wrist.

Preparation

• No special fasting or medication adjustments are typically required.
• Patients may undergo a fitting session to ensure the wrist unit will be appropriately aligned and comfortable.
• Preliminary assessments may include evaluating the current prosthesis and the patient’s needs and physical capabilities.

Procedure Description

1. Initial Assessment: The patient's current prosthesis and requirements are evaluated.
2. Prosthetic Modification:
   • The existing prosthetic device is adjusted to accommodate the flexion/extension wrist unit.
   • The wrist unit is attached, ensuring it aligns well with the rest of the prosthesis.
3. Adjustment and Calibration:
   • Friction settings, if applicable, are adjusted for optimal movement.
   • The unit is calibrated to match the patient’s desired range of motion and resistance.
4. Fitting and Testing:
   • The patient tries the modified prosthesis to ensure comfort and functionality.
   • Adjustments are made as needed.
   • Patient is instructed on the use and maintenance of the new wrist unit.

Duration

The procedure typically takes about 1-2 hours, including assessment, attachment, adjustment, and fitting.

Setting

Usually performed in a prosthetics and orthotics clinic or an outpatient rehabilitation center.

Personnel

• Certified Prosthetist
• Prosthetic Technicians
• Occasionally, an Occupational Therapist

Risks and Complications

• Misalignment causing discomfort or reduced function.
• Skin irritation or pressure sores if fitting is not optimal.
• Possible need for further adjustment or replacement parts over time.
• Mechanical failure of the wrist unit, though rare.

Benefits

• Increased wrist mobility, imitating natural movement.
• Enhanced range of motion for daily activities.
• Personalized adjustment for optimal performance and comfort.
• Psychic and emotional upliftment due to improved prosthesis function.

Recovery

• Minimal recovery time as the procedure involves modifying an existing prosthesis.
• Patients are usually able to use the modified prosthesis immediately.
• Follow-up appointments may be scheduled to ensure optimal fit and function.

Alternatives

• Use of a rigid wrist unit with no flexion/extension capability.
  • Pros: Simplicity and potentially lower cost.
  • Cons: Reduced functionality and flexibility.
• Myoelectric wrist units that offer powered movement.
  • Pros: Advanced functionality with powered movement.
  • Cons: Higher cost and requires regular maintenance.

Patient Experience

• The fitting process might involve some initial discomfort as adjustments are made.
• Patients typically experience significant improvement in prosthetic function.
• Pain management is usually unnecessary; however, patients will be advised on measures to avoid skin irritation.
• Comfort measures include ensuring proper alignment and fit during the adjustment phase.