Friday, May 27, 2022

Shower/swim leg results

Marty Mandelbaum

Thanks to all that have responded, your comments were helpful. If you have

specific billing or coding suggestions

please forward them as well. However I will not post billing issues to list

only privately to those that are interested.

Thank you

Marty Mandelbaum CPO

Responses to: Does anyone have suggestions for types of swim or shower legs

(BK’s and AK’s)?

Componentry, suspensions, techniques and coding/pricing suggestions would be

appreciated.

Please let me know if you do not want your name posted when posting

responses.

Marty:

-We use primarily two techniques for swim/shower limbs: the Endoflex

thermoplastic system and a hollow exoskeletal technique popularized by the

German’s many years ago. We usually bill them as such and seek approval in

addition to the daily use limb, often at a reduced or discounted rate that

we

negotiate based on the duplication of an existing positive mold etc. As far

as feet go, USMC has a marginal foot called the Beach Comber which we have

used; there is a swimming foot/fin by the folks who also make the Active

Ankle which works well; and we generally utilize any foot we can waterproof

effectively. For AK’s we have used the nylon knee unit that is produced by a

small company relatively new to the scene. If you want the name e-mail me

back and I’ll track it down. Good luck getting Medicare to pay for a second

prosthesis however, in our region that is not possible regardless of

functional levels/activities. Hope this helps.

Jim Rogers, CPO

Marty:

-Tony Denson has a shower limb which may be OK for both BK and AK amps. Tony

can be reached at [email protected] Endolite has a BK shower limb and I

believe is working on an AK shower Limb. They are available at

[email protected]

Bob Brown, Sr. CPO, FAAOP

Marty,

-I have had a run of patients requesting a swim leg lately. All have

admitted to actually swimming only 2-3 times a year, so I tell them if they

can get their insurance to cover it, I’ll do it. I don’t think it’s ethical

to bill for a swim leg unless I have an amputee who actually uses it

regularly (vs 2-3 times in a year). However, I have two alternatives for

swim/shower Px.

When I was in Harmarville tech school (long, long ago) we made a swim leg

using PVC piping, foam, then laminating. The pipe extended from the foot to

a hole in the distal socket and had four extensions running perpendicular to

this piece (open holes in the lamination where the pipe was). Water filled

it so that it didn’t float when swimming. It was very rudimentary, but was

an inexpensive alternative and something you could easily do in your lab. I

could explain this further if you’re interested. Give me a reply e-mail.

Secondly, for shower only Px: When making a new Px, save the check socket.

Have the patient bring in an old Px that they won’t use again. Attach the

check socket (maybe add some vent holes distally) to the old prosthesis. It

will eventually rust out, but they should be able to get years out of it for

the shower only. You can’t bill for this (as far as I know or at least I

have never tried), but it’s simple to do. The patient paid for the check

socket, after all, and it should take only a few minutes to transfer out the

sockets. We do this on occasion. You can add a wedge under the Px heel to

simulate heel height. You can even pull plastic over the metal parts to

help protect them somewhat. You’re not getting paid for it, so putting too

much effort into it seems rather charitable.

I am interested in reading your responses to see if others have had any

success in getting insurances to pay for this. We have only ever made one

true swim leg and it was ordered through a VA clinic. None of my patients

have ever pursued it.

Good luck to you and I hope this has helped or at least given you some

ideas.

Joan Cestaro, CP

RPI- Winchester VA

hello

-i suppose it would be better to use a silicon sleeve with

an additional elastic knee support if your patient is going

to swim seriously. besides you should use an adjustable

ankle part to fix it in about 120 degree for swimming and

scuba diving.

good luck

-Endolite has a new shower leg out that comes with everything except socket,

which if you vacuum form or laminate should be waterproof as well. The foot

has suction cups style bottom for better grip. Call them and they will fax

you the info.

Steve Hoover, C.P.

-ENDOLITE NORTH AMERICA HAS A NEW PRODUCT WHICH MAY INTEREST

YOU CALLED AQUALIMB

ENDOLITE NORTH AMERICA

105 WESTPARK RD.

CENTERVILLE,OHIO 45459

800-548-3534

FAX 800-929-3636

[email protected]

THANKS

KEVIN HICKEY

-I was reading Marty’s repuest about swim and shower prosthesis. Instead of

making a whole new prosthes for ” only ” showering and swimming. Why not

just

put on a sock, made of rubbery material, pump out the air, to make a vacuum

around the limp and prosthes. That way you keeps the prosthes dry and it

sure is

easier, than carying a ” spare ” leg around.

One company who deals whit such a device is Tec Motion Scandinavia AB, from

Helsingborg, Sweden. The product is called XeroSox. It should be waterproof

even

for swimming at the beach.

Mary I know it wasn’t what you repuested, but I couldn’t help it. I had to

tell

about it.

Greetings

Klaus Moldt, Physiotherapist

Holstebro, Denmark

-i’m sure you already got plenty of replies – contact endolite

-This confirmation of the post from Bob Brown He knows my work because I am

talking with him about marketing the product. I have no patent yet and ir

seems that Finneston may have beat me to it with his aqualimb but I have

not

seen it yet. E mail back if you want to know more.

Tony Denson CO

-endolite makes a very inexpensive kit for BKs. Use a suction valve and a

silicone sleeve over the outside of the assembly and viola…a shower/water

leg.

Good luck,

Larry Wiley, CP

-O.K.

Call Bock, Endolite, and Endoflex to start. They all have a design and can

produce, send you the info. to do it, or refer it out for you. Also check

the Active ankle, and Ferrier Coupler. Best Regards, Richard Feldman,CPO

-Thanks for all the replys

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