Page 16 - Mobility Management, June 2019

ATP Series
Defining Ultralights
Ultralights as Long-Term Interventions
Ultralightweight chairs are also specifically designed to be long- term mobility devices. The right K0005 with the optimal setup for its user has the potential to stave off future injuries.
“This is an area where a great deal of evidence exists,” Stanley said. “The weight of the wheelchair is important, especially related to shoulder injury. This isn’t limited to propulsion; transferring the wheelchair in and out of vehicles for transpor- tation can cause extreme shoulder damage, resulting in pain, requiring therapy or surgery. The ability to configure and set
up the wheelchair — only possible with K0005 technologies — doesn’t merely make a wheelchair easier to propel. It means that the user is not expending all of their energy in propelling their wheelchair, it reduces stress on the body and conserves energy for other routine activities and allows the person to remain func- tional in their wheelchair for longer periods throughout the day.”
Rosen pointed out that another design option exclusive to the K0005 makes propulsion more efficient: “You can’t get a rigid frame in a K0004. Everybody has a little bit of movement in a folding-frame chair that they don’t have in a rigid-framed chair. I don’t like to waste an ounce of energy.”
She acknowledged that some users insist on a folding-frame K0005, usually for transportation reasons. “But generally, I try to move you toward rigid if you are propelling.”
Over a wheelchair user’s lifetime, efficiency is critical. “It also means that the user has a higher likelihood of continuing to use a manual wheelchair as opposed to requiring a power wheelchair,”
Stanley noted. “Rear wheel adjustment (horizontal and vertical), seat- to-floor height adjustment (to facilitate transfers, foot propulsion or combined foot- and upper-extremity propulsion), caster adjustment, seat-to-back angle for positioning, front frame angle options for proper foot placement or to accommodate limited range of motion: All of these adjustments, features and additional options that allow K0005 wheelchairs to be uniquely configured are critical for perma- nent and full-time users of manual wheelchair technology.”
The Ultralight as Self Expression
The ultralightweight chair also is adaptable in a way that speaks right to the hearts of wheelchair users.
“This is one of the most important things!” Roesler said. “I have had many users choose a specific model of wheelchair based solely on the color options... we can’t downplay it! The chair becomes an extension of the user, and the more it seems to match their style and personality, the more likely they are to use and thrive with the equipment.”
Rosen cited research that demonstrated how important it is for users to like their chairs. “How people in wheelchairs feel about themselves, the more decisions they get to make on how the chair looks — those things are huge in getting out in the community and doing things,” she said. “With kids, the less medical the chair looks, the more likely that other kids are going to come up to them and want to be their friend. The ability to pick hot sparkle pink or electric plum because it’s your favorite color: That’s huge to people.
“When you have an outfit on that you like and you feel really
Cracking the Codes: Manual Wheelchair Definitions
Ultralightweight manUal wheelchairs,
used by clients with so many different diagnoses and needs, are covered by a single code. But the current K0005 HCPCS code isn’t just alone. It’s also old.
Rita Stanley, VP of Government Relations for Sunrise Medical, said, “It is important to note that the manual wheel- chair K codes were established in 1993.”
Back then, Stanley said, “Ultralightweight wheelchairs were quite new and represented the first meaningful and revolutionary change for full-time manual wheelchair users. There were only a handful of manufacturers and models. Motion Designs, later Quickie Designs and now Sunrise Medical, was one of the original manufacturers of ultralightweight wheelchairs. Ultralightweight technology was revolutionary and changed the lives of people with disabilities who depended on
manual wheelchairs for their mobility.” There was plenty of cause to be excited,
Stanley added: “The features that created the initial excitement was the weight of the wheelchair (T6 aluminum versus steel) and the ability to position the propulsion wheel, which meant the wheel could
be positioned for proper and effective upper-extremity propulsion.”
Stanley said DMERC Medical Directors consulted industry representatives to develop definitions for the new codes and to determine how many codes should be established. “As one might expect,” she said, “there were significantly more standard wheelchairs on the market at the time than ultralightweight wheelchairs. In addition, evidence was scarce at that time to prove the importance of the ultralight- weight wheelchair technology.”
weighty Definitions
By definition, HCPCS K codes are temporary codes, but “there is no defined limit on how long a K code can be maintained,” Stanley pointed out. “The code descriptor has remained essentially the same since 1993.”
For the Ultralightweight K0005 chair, that descriptor is:
Weight: Less than 30 lbs.
16 JUNE2019|MOBILITYMANAGEMENT MobilityMgmt.com
RANDOM NUMBERS: PIXABAY/GERD ALTMANN