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Ankle Foot Orthoses and the Role of an Orthotist

Ankle foot orthoses (AFOs) are a type of brace designed to provide support, and joint alignment of the foot and ankle for patients with neurological or musculoskeletal caused walking disorders or muscle weakness.  Some conditions that can cause muscle weakness include cerebral palsy, stroke, or multiple sclerosis.  A prescription for AFOs are typically written by a physician, and they are custom made for each patient from plastic, carbon, or metals with varying levels of rigidity (Hanger Clinic, 2020).

Orthotics such as ankle-foot orthosis are among the many kinds of orthotics that are an integral part of life care planning to meet an individual’s needs, especially in children with conditions where early treatment is beneficial.  As stated by cerebralpalsy.org (2020), orthotics may help establish normal patterns of joint and muscle motion by:

  • Providing a stable base for movement
  • Establishing an efficient gait
  • Minimizing the effects of spasticity in limbs
  • Creating an environment in which a child can take repeatable steps
  • Reducing excessive energy used to move
  • Aiding the transition between sitting and standing
  • Reducing, or eliminating, hip and knee hyperextension, missteps
  • Reducing the potential for accidents
  • Increasing a child’s ability to function physically and mentally
  • Strengthening weak muscles
  • Controlling muscular imbalances
  • Correcting poor skeletal alignment
  • Preventing deformity
  • Providing a stable base of support

AFOs are custom made by an orthotist, which is a health practitioner trained in the assessing, customizing, and fitting of different kinds of braces (American Academy of Orthotists & Prosthetists, 2020).  The process of a custom design involves an orthotist evaluation, which includes an assessment of muscle strength and joint mobility, the patient’s gait, and consideration of any other contributing factors or underlying disease processes for that patient (Hanger Clinic, 2020).

Orthotics and Prosthetic (O&P) services are coded with CPT and HCPCS codes. CPT codes are used for the management and training of orthoses and prostheses (97760 ā€“ 97763). HCPCS ā€˜Lā€™ codes are specific to the procedures and devices provided; codes and definitions can be found at https://hcpcs.codes/l-codes/?page=1.

97760 – Orthotic(s) management and training (assessment and fitting), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter; each 15 minutes. PT/OT/Orthotics

97761 – Prosthetic(s) training, upper and/or lower extremity(ies); initial encounter; each 15 minutes. Prosthetics

97763 – Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter; each 15 minutes. PT/OT/Orthotics & Prosthetics

References

American Academy of Orthotists & Prosthetists (2020).  Careers in Orthotics & Prosthetics.  Retrieved from https://www.oandp.org/page/careers#:~:text=Orthotists%20and%20prosthetists%20evaluate%20patients,%2C%20running%2C%20grasping%20and%20balance

CerbralPalsy.org (2020). Orthotic Devices. Retrieved from https://www.cerebralpalsy.org/information/mobility/orthotics

Hanger Clinic, (2020).  Ankle Foot Orthoses. Retrieved from https://hangerclinic.com/orthotics/ankle-foot/ankle-foot-orthoses/

PMIC Digital Book Series: Medical Fees 2020. (2019). Los Angeles, CA: Practice Management Information Corporation.