Lateral control on spinal orthoses

Lateral control on spinal orthoses

David Hendricks

4/15/2014

Dear Colleagues,

Let me begin with a question, then add some background. My question is, what
is the rationale for a higher reimbursement for a spinal orthosis when
lateral (coronal-plane) control is added? That is, for which pathologies is
lateral control indicated? (I'm talking here about adult spinal bracing.)

I was in France last week, comparing notes with a colleague about spinal
bracing requirements in each country. We were both surprised at how
different-even opposite-those requirements are. For example, she told me
that her government only reimburses for a spinal orthosis if it's made from
elastic. I told her that, here, an all-elastic brace would not be covered at
all. I went on to explain that we must include anterior and posterior
plastic plates in our spinal orthoses and she countered that theirs must
include anterior and posterior rigid stays, but that plastic plates would
not qualify in their stead.

I explained our system using the example of three common US adult spinal
codes: L0627, L0631, and L0637. When I got to the last and said that our
government pays more if lateral plastic plates are added for coronal
control, she raised her eyebrows and said, Here they would pay nothing for
that! She looked thoughtful, then added, in fact, I don't even know what
it would be for. What conditions would be helped by that?
I tried to answer to her question, but neither of us were satisfied with my
response, so I told her I would pose her question for my esteemed colleagues
in my country for a better answer. What pathologies might be helped by the
addition of coronal-plane control to a brace that already contains
sagittal-plane control?

Thanks, in advance, for your thoughtful responses.

David Hendricks, CPO


David Hendricks, CPO
Chief Medical Officer
Townsend Design
407-697-9481
<Email Address Redacted> <mailto:<Email Address Redacted>>