Thanks very much for all the responses I received. I have compiled the info
for anyone out there who is interested.
The question is;
Does anyone use Check/Test socket, or a throwaway preparatory KAFO. If you
do what do you call it? If you do use one, can you give a brief
description, and you reasoning/rational.
I would like to note, the other names used Test Orthosis, or Diagnostic
Check Orthosis(DCO). What does the OandP community thinks.
I personally never do a KAFO without doing a Test Orthosis (sounds weird), I
feel that if the cast is good, with a Test Orthosis, the KAFO can be Better.
It reduces remakes or any adjustments. I’m surprise that there were so few
responses, my feeling is because there is no L code paying for this item.
My thought, my adjustment time and cost, is worth more than our techs. cost.
The following are answers I received form the above question.
Dear John,
I am suffering from Post-Thanksgiving stuffing so pardon my question for
clarifying your question of the “throwaway KAFO? I have at times made a
fitting KAFO for office purposes in some materials that I would not
carryover into the definitive Orthosis. I have done this only on the most
difficult cases. To be consistent with Prosthetics, I would name it a Test
Orthosis.
Let me know if I answered you correctly,
Pat
Yes John, I use check sockets when I suspect, for various reasons that the
fitting may not be as ‘straight forward’ as usual. These occasions are
sometimes when the limb residuum is beset by complications or when I wish to
change the type of socket that the patient is accustomed to. Occasionally,
during modification, I wish to alter the overall philosophy of the socket
i.e. weight-bearing areas, volume changes or alignment, etc. so I will test
my theories with a check socket. Once or twice the positive cast has been
damaged in transit, so a check socket has tested the veracity of the
repairs.
I have never used a similar system with a KAFO. I suppose that the metal
KAFO’s give enough malleability to make running alterations to the
‘definitive’ article and plastic ones almost equally so and volume is not as
critical as a ‘stump container’.
Richard Ziegeler P&O.
When I am doing Oregon Orthotic System AFOs and KAFOs, I routinely use what
OOS has termed a Diagnostic Check Orthosis(DCO). At the moment there are no
appropriate L codes for these, so I have been forced to use prosthetic codes
for BK and AK check sockets. I feel comfortable doing this as there is
quite a bit more involved in either DCOs than there is in the prosthetic
counterpart.
The fitting of my final orthosis is much better using these DCOs, especially
in a laminated system where there is little room for error.
Richard Lux, CO Lux orthotics
That’s all for now.
