My original question was:
Does anyone have an established definition for the term “prosthetic diagnosis”.
The only definitions I can find in web searches are for dental conditions.
Replies follow:
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I believe that would be: “amputation” then specify left or right /
below, above, or upper limb. Example below:
ICD9 Codes of Interest to a Neurologist …. bka – below knee
amputation, 897. aka – above knee amputation, 897.2. orthotic
training, V57.81 …
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I will be looking forward to seeing the responces to your great
question! I would think it would be something like this:
The prosthetic type, derived from evedence based practice –
evaluation of medical history and physical needs as demonstrated.
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Would you first not have to defind what type of prosthetic areas are
being discussed? Invasive Replacement
External limb/dental/optical
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How about amputation. The two words don’t belong in that sequence,
there is no defintion. How about diagnosis for prosthesis;eg,
congenital limb deficiency, trauma, disease. A prosthetic Dx would be
that the prostheisis is not fitting because the limb has changed
voulme and/or shape; the prosthetist has diagnosed why there is a
prosthetic problem.
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Let me know what responses you get.
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Ted, and all on this list – this is the first I’ve heard of such a term as
“prosthetic diagnosis”. And I’m wondering why one would want to create such
a term. The terms are incongruent – they conflict with one another. My
understanding of diagnosis is the art of examination, identifying symptoms,
evaluation, investigation, analyzing and deciphering the cause of problem[s]
and /or disease – relating to living organisms, usually humans and animals.
I don’t know how this can be applied to a prosthesis – an inanimate object.
Unless of course you are referring to the diagnosis of a particular problem
a patient is experiencing with the function of a prosthesis – an external
extremity prosthesis.
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The term prosthetic diagnosis based on Medicare and CMS relate to those
diagnoses that require prosthetic intervention. These may include dental,
internal and external prostheses. In addition external prosthetics are based
on amputation diagnoses as the cause for need, the medical cause such as
infection and the need for surgical intervention cause the amputation.
Unfortunately when you are dealing with some of these manuals the people who
right them do not understand the difference between one or the other and the
need to state things in order. I hope this helps. If there is a specific
problem with an insurance claim or social worker I would be happy to help
reference the definitions and explanations. As a prosthetist you are well
aware of people who do not understand what we do.
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Ted, try this. Though it is not a direct defintition, but it
determines what falls into the category. Sorry for fat red highlite,
I was intending to underscore, and now can’t remove it. Basically,
will it be safe to say that prosthetic Rx should be one for items
mentioned as prosthesis for a prosthetist scope of practice? Also,
something tells me Medicare has defintion very similar to this. Know
for sure, they have one for orthoses. This is from WA state licensure:
RCW 18.200.010
Definitions.
The definitions in this section apply throughout this chapter unless
the context clearly requires otherwise.
(7) “Prosthetics” means the science and practice of evaluating,
measuring, designing, fabricating, assembling, fitting, aligning,
adjusting, or servicing, as well as providing the initial training
necessary to accomplish the fitting of, a prosthesis through the
replacement of external parts of a human body lost due to amputation
or congenital deformities or absences. The practice of prosthetics
also includes the generation of an image, form, or mold that
replicates the patient’s body or body segment and that requires
rectification of dimensions, contours, and volumes for use in the
design and fabrication of a socket to accept a residual anatomic limb
to, in turn, create an artificial appendage that is designed either
to support body weight or to improve or restore function or cosmesis,
or both. Involved in the practice of prosthetics is observational
gait analysis and clinical assessment of the requirements necessary
to refine and mechanically fix the relative position of various parts
of the prosthesis to maximize the function, stability, and safety of
the patient. The practice of prosthetics includes providing
continuing patient care in order to assess the prosthetic device’s
effect on the patient’s tissues and to assure proper fit and function
of the prosthetic device by periodic evaluation.
(8) “Prosthetist” means a person who is licensed to practice
prosthetics under this chapter.
(9) “Prosthesis” means a definitive artificial limb that is
alignable or articulated, or, in lower extremity applications,
capable of weight bearing. Prosthesis means an artificial medical
device that is not surgically implanted and that is used to replace a
missing limb, appendage, or other external human body part including
an artificial limb, hand, or foot. The term does not include
artificial eyes, ears, fingers or toes, dental appliances, ostomy
products, devices such as artificial breasts, eyelashes, wigs, or
other devices as determined by the secretary that do not have a
significant impact on the musculoskeletal functions of the body. In
the lower extremity of the body, the term prosthesis does not include
prostheses required for amputations distal to and including the
transmetatarsal level. In the upper extremity of the body, the term
prosthesis does not include prostheses that are provided to restore
function for amputations distal to and including the carpal level.
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I am also interested in this – Could you send me any responses you receive?
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Huh? what do you mean?
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You have got to be kidding us.
The patient has an amputation. Therefore he/she might need a prosthesis.
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I’m not sure if I understand your question. Do you mean the ICD9 code
such as V43.7 “Limb replaced by other means”.
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End of responses:
As you see the responses are diverse and even seem to present an
emotional response to the question on occasion. The concept of
“Prosthetic Diagnosis” is not all that unusual. The terms “nursing
diagnosis” and “physical therapy diagnosis” are commonly used and a
routine part of the classroom in those fields. Perhaps it is
reasonable to ask if such a concept does not have application in our
own profession and if it does, then perhaps a clear and consistent
definition should be agreed upon.
Thank you.
Ted A. Trower C.P.O., FAAOP
A-S-C Orthotics & Prosthetics
Jackson, Michigan, USA
www.amputee.com
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