Like most of everything else in the medical community, prosthetics and access to those devices are determined by the insurance industry. Specific to prosthetics, CMS sets the standard for coverage and availability. For an amputee, their assigned K-level will ultimately lead the determination for what technology a patient will receive.
The K-Level is a functional level assigned to each amputee by their physician. Ironically, most doctors aren't familiar with K-levels and rely heavily upon the prosthetists' recommendation. The higher the k-level, the more active the patient.
Currently, microprocessor knees are covered by insurance for individuals who are labeled k-3. K-3 are higher activity individuals- a simplified version is a mild weekend athlete. Someone who is busy throughout the day, walks on several surfaces without an issue and can traverse stairs and ramps. K-2 individuals have been limited to mechanical knees in lieu of the technology.
Numerous studies have proven that microprocessor knees, especially with their stumble recovery, are life changing for the k-2 population. The computer technology has shown vast improvement in both the mobility and the quality of life for above-knee amputees for more than a decade. Finally, CMS is considering changing the classification for microprocessor knees to allow access to the k-2 population.
A draft LCD has been proposed to allow access to microprocessor technology for this community. You can read the proposal here. I hope you consider writing an email of support for this draft LCD. This technology is changing lives!
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