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Upper extremity prosthesis, not otherwise specified

HCPCS code

Name of the Procedure:

Common Name: Custom Fit Upper Extremity Prosthesis
Technical Term: Upper Extremity Prosthesis, Not Otherwise Specified (L7499)

Summary

An upper extremity prosthesis is a device designed to replace the function and appearance of an arm or hand that has been lost due to disease or injury. This custom fit prosthesis is tailored to meet the unique needs of the individual.

Purpose

The primary goal of this procedure is to restore functional abilities and enhance the quality of life for individuals who have lost all or part of their upper limb. It aims to provide the patient with the ability to perform daily activities, improve overall mobility, and boost self-confidence.

Indications

Specific symptoms or conditions that warrant the procedure include:

  • Congenital limb deficiencies
  • Traumatic limb loss
  • Surgical amputation due to infection or cancer Patient criteria making the procedure appropriate:
  • Sufficient physical health to support the use of a prosthesis
  • Commitment to rehabilitation and proper use

Preparation

Pre-procedure instructions for the patient:

  • No special preparation such as fasting is generally required.
  • Patients should discuss current medications with their healthcare provider. Required diagnostic tests or assessments:
  • Comprehensive physical and functional assessment
  • Psychological evaluation if necessary

Procedure Description

  1. Initial Assessment: Measure the affected limb and evaluate the patient’s needs.
  2. Customization: Design a prosthetic that fits comfortably and meets functional requirements.
  3. Fitting: The prosthesis is fitted, adjusted, and fine-tuned.
  4. Training: Teach the patient how to use and maintain the prosthesis. Tools and Equipment: Measurement tools, materials for molding and prosthesis fabrication, fitting and adjustment instruments. Anesthesia or Sedation: Usually not required for the fitting process.

Duration

The process can take several weeks from initial assessment to final fitting, involving multiple appointments.

Setting

The procedure is typically performed in a specialized prosthetics clinic or rehabilitation center.

Personnel

Healthcare professionals involved:

  • Prosthetist
  • Physical Therapist
  • Occupational Therapist
  • Occasionally, a Surgeon for initial assessment

Risks and Complications

Common risks:

  • Skin irritation or blistering from the prosthetic socket
  • Improper fit leading to discomfort Rare risks:
  • Infection due to skin abrasions
  • Psychological impact of adjustment period

Benefits

Patients can expect to regain some level of functional ability and independence. The psychological benefits of improved appearance can also be significant. Most benefits are realized within a few weeks of successful usage and rehabilitation.

Recovery

Post-procedure care:

  • Follow-up appointments for adjustments and assessments.
  • Daily skin care to prevent irritation. Expected recovery time:
  • Varies depending on the patient’s condition and adaptation period. Typically, full adaptation can take several months.

Alternatives

Other treatment options include:

  • Physical therapy without prosthesis
  • Use of assistive devices like wheelchairs or adaptive tools Pros and Cons Comparisons:
  • Prosthetics offer greater functional restoration compared to other devices but require a longer adaptation period and financial investment.

Patient Experience

Patients might experience a range of emotions during adaptation, from excitement to frustration. Initial discomfort is common as the body adapts. Pain management strategies include over-the-counter medications and proper prosthesis fitting adjustments. Comfort measures include padded liners and regular follow-up visits to address any issues promptly.

Medical Policies and Guidelines for Upper extremity prosthesis, not otherwise specified

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