While physicians are tasked by the Centers for Medicare
& Medicaid Services (CMS) to assign K-level
functional classifications to lower-limb amputee
patients, some turn to prosthetists for guidance.
Compassion, and even profit margin, can drive
prosthetists then to suggest to the physician that he or she assign a
lower-limb amputee patient with a higher K-level based on potential
rather than reality. If that occurs, the patient has to live with the
consequences, be it a device that is too cumbersome or perhaps
too heavy. Conversely, if the K-level determination errs on the
side of caution and the patient is provided a lower-functioning
technology, then his or her performance will be limited, says Brian
Kaluf, BSE, CP, managing practitioner of the Ability Prosthetics
& Orthotics Greenville, South Carolina, patient care facility
and Ability’s clinical outcome and research officer. To address the
ambiguity surrounding support for K-level assignment, reduce
subjectivity, and better serve its patients, Ability, headquartered
in Exton, Pennsylvania, instituted a policy whereby all prosthetic
patients who visit any of its ten patient care facilities are evaluated
using prosthetic outcome measures.
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