Name of the Procedure:

Upper Extremity Addition, Silicone Gel Insert or Equal (HCPCS Code L6692)

Summary

An Upper Extremity Addition, Silicone Gel Insert, is a medical procedure where a silicone gel insert is added to a prosthesis or orthotic device used on the upper limb (arm or hand). This insert helps to improve the fit and comfort of the device.

Purpose

The purpose of adding a silicone gel insert is to enhance the fit, provide better cushioning, and reduce friction and skin irritation for individuals using upper extremity prosthetic or orthotic devices. The goal is to improve overall comfort and usability, potentially increasing the user's daily function and mobility.

Indications

This procedure is indicated for individuals who:

• Use upper extremity prosthetic or orthotic devices.
• Experience discomfort, pressure sores, or skin irritations due to improper fitting of their device.
• Require improved device fit for better limb control and function.
• Have specific conditions like amputation or musculoskeletal disorders that necessitate the use of such devices.

Preparation

Preparation for the addition of a silicone gel insert may involve:

• Discussing your medical history and prosthesis usage with your healthcare provider.
• Possibly attending a fitting session to take measurements or mold impressions.
• No specific fasting or medication adjustments are generally required.

Procedure Description

1. The healthcare provider will assess the current fit and condition of the prosthetic or orthotic device.
2. Measurements or mold impressions may be taken to ensure a custom fit for the silicone gel insert.
3. The silicone gel insert is then shaped or selected based on the assessment.
4. The insert is placed into the device where it aligns with the patient's upper extremity, ensuring a snug and comfortable fit.
5. Adjustments may be made to ensure optimal placement and comfort.

Tools and Equipment:

• Measurement tools or molds.
• Silicone gel insert (custom or pre-sized).
• Adjusting tools specific to the prosthetic or orthotic device.

Anesthesia or sedation is not typically required for this procedure.

Duration

The procedure usually takes about 30 minutes to 1 hour, depending on the complexity and the need for adjustments.

Setting

This procedure is usually performed in an outpatient clinic or an orthotic/prosthetic practitioner’s office.

Personnel

• Orthotist or prosthetist
• Medical support staff (e.g., nurses)

Risks and Complications

Common risks:

• Minor skin irritation during the adjustment period.

Rare risks:

• Allergic reaction to the silicone material.
• Incorrect fit leading to discomfort or need for further adjustments.

Benefits

• Improved comfort and fit of the prosthetic or orthotic device.
• Reduced risk of pressure sores and skin irritation.
• Enhanced limb function and mobility.
• Most patients experience immediate comfort improvements.

Recovery

• Little to no recovery time is needed.
• Patients may need to attend follow-up appointments for adjustments.
• Instructions on care and cleaning of the insert and device will be provided.

Alternatives

• Adjustment or replacement of existing prosthetic/orthotic components without silicone inserts.
• Use of other cushioning materials or liners. Pros and Cons:
• Silicone inserts offer superior cushioning and durability compared to alternatives.
• Alternatives might be less costly but may not provide the same level of comfort.

Patient Experience

• During the procedure, patients will feel minimal discomfort as no invasive techniques are used.
• After the procedure, patients might need a short adjustment period to get used to the new insert.
• Pain management is generally not necessary, but any discomfort can usually be managed with over-the-counter pain relief if needed.