Name of the Procedure:

Addition to Upper Extremity Prosthesis, Below Elbow/Above Elbow, Custom Fabricated Socket Insert for Congenital or Atypical Traumatic Amputee, Silicone Gel, Elastomeric or Equal, for Use with or Without Locking Mechanism, Initial Only
(HCPCS Code: L6696)

Summary

This procedure involves adding a custom-fabricated socket insert, made from silicone gel or similar materials, to an upper extremity prosthesis. The insert is specifically designed for individuals with congenital or atypical traumatic amputations. It aims to provide improved comfort and fit, and can be used with or without a locking mechanism.

Purpose

This procedure addresses the need for a comfortable and well-fitting prosthetic socket for individuals with unique upper extremity amputation profiles. The main goals are to enhance the user’s comfort, improve the prosthesis fit, and potentially reduce skin irritation.

Indications

• Congenital amputations of the upper extremity (below or above elbow)
• Atypical traumatic amputations of the upper extremity
• Discomfort or poor fit with standard prosthetic sockets
• Sensitive or easily irritated residual limb skin

Preparation

• No specific fasting or medication adjustments required.
• Medical history review and physical examination of the residual limb.
• Measurement and molding of the residual limb for custom socket fabrication.

Procedure Description

1. Measurements and Casting: The residual limb is measured and a cast is taken to create a precise model.
2. Fabrication: Using the cast, a custom socket insert is fabricated from silicone gel or an elastomeric material, ensuring a perfect fit.
3. Installation: The insert is integrated into the prosthetic socket, with adjustments made for optimal comfort and function.
4. Fitting: The prosthesis with the new socket insert is fitted on the patient, ensuring compatibility and comfort.

Tools and Equipment: Measuring tools, casting materials, and fabrication equipment for prosthetics. Silicone gel or elastomeric materials for the insert.

Anesthesia or Sedation: None required.

Duration

The entire process, from measurement to fitting, may span several appointments over a few weeks. Each appointment typically lasts 1-2 hours.

Setting

• Outpatient clinic specializing in prosthetics.
• Prosthetic fabrication laboratory.

Personnel

• Prosthetist.
• Prosthetic technician.
• Healthcare provider for assessment and follow-up.

Risks and Complications

• Skin irritation or allergic reactions to materials used.
• Ill-fitting insert requiring adjustments.
• Infection if skin is broken during fitting.

Benefits

• Enhanced comfort and fit of the prosthesis.
• Reduced skin irritation and pressure sores.
• Improved prosthetic functionality.

Recovery

• Immediate use of prosthesis post-fitting.
• Regular follow-up appointments for adjustments.
• Limited physical activity initially, progressing as comfort improves.

Alternatives

• Standard prosthetic socket without a custom insert.
• Different types of prosthetics (e.g., myoelectric).
• Pros and Cons: Standard sockets may not fit as well or be as comfortable; other prosthetic types might not suit the patient’s specific needs or conditions.

Patient Experience

• During the Procedure: Minimal discomfort during measurement and casting; no pain.
• After the Procedure: Enhanced prosthetic comfort; possible mild initial discomfort as the residual limb adapts to the new socket.
• Pain Management: Over-the-counter pain relief if needed; monitoring for skin irritation.

This custom socket insert aims to significantly improve the quality of life for individuals with congenital or atypical traumatic upper extremity amputations by providing a more comfortable and functional prosthetic experience.