Name of the Procedure:

Upper Extremity Addition, Harness (e.g., Figure of Eight Type), Dual Cable Design
HCPCS Code: L6676

Summary

This procedure involves the fitting and installation of a specialized harness for individuals who require support and enhancement of upper limb function. The harness uses a figure-of-eight design and a dual cable system to provide improved mechanical leverage and functional capabilities for individuals with upper limb impairments.

Purpose

The procedure aims to assist individuals with upper limb deficiencies or amputations in gaining better control and functionality of their prosthetic limbs or orthopedic devices. The outcome is to enhance the user's ability to perform daily activities with greater ease and independence.

Indications

This harness is particularly suitable for patients with:

• Upper limb amputations
• Muscular or neurological conditions affecting upper limb function
• Individuals needing additional support and control for prosthetic devices.

Preparation

Patients may need to:

• Undergo measurements for a custom fit of the harness.
• Attend an assessment session with a prosthetist to ensure the harness will provide the necessary support and functionality.
• No specific fasting or medication adjustments are typically required, though individual cases may vary.

Procedure Description

1. Assessment: The prosthetist assesses the patient’s needs and takes detailed upper limb measurements.
2. Fitting: The harness is custom-fitted, ensuring the figure-of-eight design and dual cables align correctly for optimal function.
3. Adjustment: The dual cable system is adjusted to match the patient’s range of motion and strength requirements.
4. Training: The patient is educated on how to wear, adjust, and maintain the harness properly.

Tools and Equipment:

• Custom figure-of-eight harness
• Dual cable system
• Adjustment tools dictated by the prosthetic setup

Anesthesia: None required.

Duration

The fitting process typically takes about 1 to 2 hours, including patient education and training.

Setting

The procedure is generally performed in an outpatient clinic specializing in prosthetics or orthotics.

Personnel

• Certified Prosthetist/Orthotist
• Rehabilitation Specialist (if needed)

Risks and Complications

• Skin irritation or pressure sores
• Discomfort due to improper fitting
• Mechanical failure of cables (rare)

Management: Regular follow-ups and adjustments can mitigate these issues.

Benefits

• Improved control and functionality of the upper limb.
• Increased independence in daily activities.
• Enhanced quality of life.

The benefits can often be realized immediately after the fitting and adjustment process.

Recovery

• Follow-up appointments for adjustments as needed.
• Regular maintenance of the harness.
• No significant downtime; patients can typically resume regular activities immediately.

Alternatives

• Single cable systems
• Traditional halter harnesses
• Electromechanical prosthetics

Pros and Cons:
Single Cable Systems: Less support compared to dual cable.
Traditional Halter Harnesses: Less mechanical advantage, simpler design.
Electromechanical Prosthetics: Advanced functionality, higher cost.

Patient Experience

• During Procedure: Patients may feel some discomfort during the initial fitting.
• After Procedure: Users often experience improved limb control. Any discomfort or issues can generally be managed with follow-up visits.

Pain Management: Generally, non-invasive, and discomfort is minimal. Over-the-counter pain relief may be used if necessary.