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Coverage criteria policies

Prosthesis - upper limb - effective 1/1/2019

These services may or may not be covered by all HealthPartners plans. Please see your plan documents for your own coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

Prior authorization is required for:

  • Prosthetic limb
  • Occupational therapy after 20 visits. An occupational therapy program is recommended if the patient is either a new amputee and this is the first prosthetic fitting or this is a subsequent fitting where there is a change in the technology (i.e. switching from body powered to myoelectric, etc.). See Physical and Occupational Therapy – Rehabilitation policy for details.

Prior authorization is not required for:

  • Prosthetic repairs, adjustments and/or modifications.
  • Prosthetic accessories such as stump/prosthetic sheaths/sleeves and harnesses when these appliances aid in or are essential to the effective use of the prosthesis.

Coverage

Upper limb prostheses are generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

  1. An upper limb prosthesis may be covered to treat individuals with upper limb amputation or congenital absence of the upper limb when determined to be medically necessary by the treating physician and the prosthetist to perform activities of daily living (ADLs). Supporting documentation should include:
    1. Past medical history including prior prosthetic use.
    2. An explanation of the member’s current medical condition, including the status of the residual limb and the nature of other medical problems.
    3. Confirmation of the member’s motivation and desire to use the limb.
    4. Confirmation of the member’[s ability to obtain or maintain a defined functional state for daily ADLs within a reasonable period of time.
  2. The types of limbs listed below are eligible for coverage when all of the associated medical criteria are met :
    1. Passive functional: This type of prosthesis does not include any mechanical working parts. It is best used for a partial hand amputation to provide functions such as opposition and dexterity. A passive functional prosthesis may be covered only when there is clear documentation that the requested prosthesis is required to perform ADL’s. In the absence of this documentation, the request will be denied as cosmetic.
    2. Mechanical (body-powered): This type of prosthesis uses body movements to operate a terminal device (hand or hook). The prosthesis is connected to the body through the use of cables and harness. Movements of the shoulders and arms opens and closes the terminal device. A mechanical prosthesis may be covered when all of the following criteria are met:
      1. Documentation indicates that the prosthesis is required to perform ADLs;
      2. Documentation indicates that the member has the necessary strength and excursion to operate the requested body-powered prosthetic.
    3. Myoelectric (externally powered): This type of prosthesis uses signals from muscles of the residual limb to control the opening and closing of the terminal device (hook or hand) or elbow depending on the level of amputation. Electrodes are incorporated in the prosthetic socket. By contracting the muscles of the residual limb, electrical signals are sent to the motors which open and close the terminal device or lift and lower the forearm at the elbow. Myoelectric upper limb prosthesis components may be covered when all of the following criteria are met:
      1. Prosthetist’s notes are submitted which indicate the rationale for myoelectric recommendations, including documentation of why a standard body-powered prosthesis cannot be used or is insufficient to meet the functional need of the member in performing ADLs;
      2. The member has adequate cognitive, musculoskeletal, and neurological ability to utilize a myoelectric prosthesis;
      3. The remaining musculature of the arm is sufficient to allow operation of a myoelectric device.
  3. Sockets/Socket Inserts and Sleeves: No more than two test (diagnostic) sockets will be covered for an individual prosthesis without additional documentation of medical necessity. No more than two of the same socket inserts /sleeves are allowed at the same time. Socket and socket insert/sleeve replacements are considered medically necessary if there is documentation of functional and/or physiological need. Explanation to include but is not limited to:
    1. Changes in residual limb
    2. Functional need changes
    3. Irreparable damage due to wear and tear
    4. Wear and tear due to excessive weight
    5. Prosthetic demands of a very active amputee
  4. Accessories: Accessories such as stump socks, harnesses and batteries are covered only when they aid in or are essential to the effective use of the prosthesis.
  5. Adjustments. Adjustments and/or modifications to the prosthesis required by wear and tear or due to a change in individual's condition (such as growth in a child) or to improve the function are covered.
  6. Repairs. Repairs necessary to make the prosthetic functional are covered. The expense for repairs may not exceed the estimated expense of purchasing another prosthesis.
  7. Replacement: Replacement of a complete prosthesis or its components will be reviewed according to the following criteria:
    1. Replacement of a prosthetic limb component (other than those specifically listed as not requiring prior authorization) is eligible for coverage when clinical documentation indicates:
      1. There is a change in the physiologic condition or functional level of the member which necessitates replacement of the requested component(s); or
      2. There is an irreparable change in the condition of the component that is not a result of misuse or neglect; and
      3. The component is not covered under warranty
    2. Replacement of a complete prosthesis is eligible for coverage according to the criteria listed in #1-4 above when clinical documentation indicates:
      1. There is a change in the physiologic condition or functional level of the member which causes the prosthesis to become non-functional; or
      2. The condition of the prosthesis requires repairs which would exceed the estimated expense of purchasing a new prosthesis.
    3. Replacement of a functional prosthesis or its components solely for the purpose of upgrading or acquiring newer technology is considered not medically necessary.

Indications that are not covered

  1. A partial or full hand prosthesis with individually powered digits, is considered investigational due to lack of reliable clinical evidence in the form of high quality, peer-reviewed medical literature to establish the safety and efficacy of this treatment or its effect on health care outcomes.
  2. Implantable myoelectric sensors for upper limb and hand prostheses are considered investigational due to lack of reliable clinical evidence in the form of high quality, peer-reviewed medical literature to establish the safety and efficacy of this treatment or its effect on health care outcomes.
  3. A prosthesis is considered cosmetic and is not covered when requested for appearance alone. Medical Necessity requires that the prosthesis enables the member to conduct standard activities of daily living.
  4. Replacement of non-functional components of a prosthesis or prosthetic covering is considered cosmetic.
  5. Accessories or enhancements of the prosthesis for the purpose of recreation, vocation, comfort or convenience are not considered medically necessary and are not covered.
  6. Duplicate or similar items (such as secondary terminal devices, e.g., heavy duty work hook) are not considered medically necessary and are not covered. Therefore, only one permanent prosthesis is covered unless a member requires bilateral prostheses for ADLs.
  7. Repairs, components, or prosthesis replacement are not covered if the plan determines that malicious damage, culpable neglect or wrongful disposition of the prosthesis has occurred.

Definitions

Activities of daily living (ADLs) refers to a set of common, everyday tasks, performance of which are required for personal self-care and independent living; bathing, dressing, eating, toileting and transferring. .

Dexterity is the ability to make coordinated hand and finger movements to grasp and manipulate objects.

Excursion is a description of distance generated by the relative movement of two body parts. For example, when you hunch or round your shoulders, you are widening the distance between your shoulder blades. That increase in distance is the 'excursion' you have generated.

Medical Necessary –means that the prosthesis is required for the member to conduct activities of daily living (ADL’s).

A microprocessor is a component of every myoelectric prosthesis and is used to interpret and analyze signals from the joint - angle sensors and moment sensors. The microprocessor receives signals from its sensors to determine the type of motion being employed by the amputee. Most microprocessor controlled joints are powered by a battery housed inside the prosthesis.

Opposition is the relation between the thumb and the other digits of the hand for the purpose of grasping objects between the thumb and fingers.

Prosthetic is the systematic pursuit of providing functional restoration of a limb.

Prosthesis is an artificial part of the body. In cases of an amputee, usually an arm or leg. There are usually several stages to prepare the limb for a permanent prosthesis.

Prosthesis/Permanent - the final prosthesis once the limb has stabilized shape and size.

Prosthesis/Preparatory - a prosthesis that prepares the limb for a permanent prosthesis. A preparatory prosthesis is used by individuals who are still undergoing changes to the residual limb. This prosthesis uses a transparent diagnostic test socket and special fitting techniques to accurately fit the prosthesis. As a result, fitting problems can be prevented before the prosthesis is cloned for the permanent prosthesis.

Prosthesis/Temporary - a prosthesis usually made soon after an amputation and once the stitches are removed (about two-six weeks post amputation). The temporary prosthesis shrinks, toughens and desensitizes the limb to prepare it for the permanent prosthesis. A lower limb temporarily helps to regain balance, relearn walking and tightening of the muscles. An upper limb temporarily helps to increase range of motion, strengthen muscles and encourage the use of both hands, preventing an individual from becoming one handed.

A Prosthetist, as defined by the American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. is a healthcare professional who measures, designs, fabricates, fits, or services a prosthesis as prescribed by a licensed physician, and who assists in the formulation of the prosthesis prescription for the replacement of external parts of the human body lost due to amputation or congenital deformities or absences. .

A Terminal Device is the component on the end of the prosthesis meant to provide a function that the hand used to provide.

If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

Codes

Description

L6000

Partial hand, thumb remaining

L6010

Partial hand, little and/or ring finger remaining

L6020

Partial hand, no finger remaining

L6026

Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)

L6050

Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad

L6055

Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad

L6100

Below elbow, molded socket, flexible elbow hinge, triceps pad

L6110

Below elbow, molded socket, (muenster or northwestern suspension types)

L6120

Below elbow, molded double wall split socket, step-up hinges, half cuff

L6130

Below elbow, molded double wall split socket, stump activated locking hinge, half cuff

L6200

Elbow disarticulation, molded socket, outside locking hinge, forearm

L6205

Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm

L6250

Above elbow, molded double wall socket, internal locking elbow, forearm

L6300

Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm

L6310

Shoulder disarticulation, passive restoration (complete prosthesis)

L6320

Shoulder disarticulation, passive restoration (shoulder cap only)

L6350

Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm

L6360

Interscapular thoracic, passive restoration (complete prosthesis)

L6370

Interscapular thoracic, passive restoration (shoulder cap only)

L6400

Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping

L6450

Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping

L6500

Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping

L6550

Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping

L6570

Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping

L6580

Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model

L6582

Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed

L6584

Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model

L6586

Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed

L6588

Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model

L6590

Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed

L6600

Upper extremity additions, polycentric hinge, pair

L6605

Upper extremity additions, single pivot hinge, pair

L6610

Upper extremity additions, flexible metal hinge, pair

L6611

Addition to upper extremity prosthesis, external powered, additional switch, any type

L6615

Upper extremity addition, disconnect locking wrist unit

L6616

Upper extremity addition, additional disconnect insert for locking wrist unit, each

L6620

Upper extremity addition, flexion/extension wrist unit, with or without friction

L6621

Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device

L6623

Upper extremity addition, spring assisted rotational wrist unit with latch release

L6624

Upper extremity addition, flexion/extension and rotation wrist unit

L6625

Upper extremity addition, rotation wrist unit with cable lock

L6628

Upper extremity addition, quick disconnect hook adapter, otto bock or equal

L6629

Upper extremity addition, quick disconnect lamination collar with coupling piece, Otto Bock or equal

L6630

Upper extremity addition, stainless steel, any wrist

L6637

Upper extremity addition, nudge control elbow lock

L6638

Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow

L6640

Upper extremity additions, shoulder abduction joint, pair

L6641

Upper extremity addition, excursion amplifier, pulley type

L6642

Upper extremity addition, excursion amplifier, lever type

L6645

Upper extremity addition, shoulder flexion-abduction joint, each

L6646

Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system

L6647

Upper extremity addition, shoulder lock mechanism, body powered actuator

L6648

Upper extremity addition, shoulder lock mechanism, external powered actuator

L6650

Upper extremity addition, shoulder universal joint, each

L6655

Upper extremity addition, standard control cable, extra

L6660

Upper extremity addition, heavy duty control cable

L6665

Upper extremity addition, teflon, or equal, cable lining

L6670

Upper extremity addition, hook to hand, cable adapter

L6672

Upper extremity addition, harness, chest or shoulder, saddle type

L6675

Upper extremity addition, harness, (e.g., figure of eight type), single cable design

L6676

Upper extremity addition, harness, (e.g., figure of eight type), dual cable design

L6677

Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow

L6680

Upper extremity addition, test socket, wrist disarticulation or below elbow

L6682

Upper extremity addition, test socket, elbow disarticulation or above elbow

L6684

Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic

L6686

Upper extremity addition, suction socket

L6687

Upper extremity addition, frame type socket, below elbow or wrist disarticulation

L6688

Upper extremity addition, frame type socket, above elbow or elbow disarticulation

L6689

Upper extremity addition, frame type socket, shoulder disarticulation

L6690

Upper extremity addition, frame type socket, interscapular-thoracic

L6691

Upper extremity addition, removable insert, each

L6692

Upper extremity addition, silicone gel insert or equal, each

L6693

Upper extremity addition, locking elbow, forearm counterbalance

L6694

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

L6695

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism

L6696

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)

L6697

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)

L6698

Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert

L6703

Terminal device, passive hand/mitt, any material, any size

L6704

Terminal device, sport/recreational/work attachment, any material, any size

L6706

Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined

L6707

Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined

L6708

Terminal device, hand, mechanical, voluntary opening, any material, any size

L6709

Terminal device, hand, mechanical, voluntary closing, any material, any size

L6711

Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric

L6712

Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric

L6713

Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric

L6714

Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric

L6715

Terminal device, sport/recreational/work attachment, any material, any size

L6721

Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined

L6722

Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined

L6805

Addition to terminal device, modifier wrist unit

L6810

Addition to terminal device, precision pinch device

L6880

Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)

L6881

Automatic grasp feature, addition to upper limb electric prosthetic terminal device

L6882

Microprocessor control feature, addition to upper limb prosthetic terminal device

L6883

Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power

L6884

Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power

L6885

Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power

L6890

Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment

L6895

Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated

L6900

Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining

L6905

Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining

L6910

Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining

L6915

Hand restoration (shading, and measurements included), replacement glove for above

L6920

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device

L6925

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L6930

Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

L6935

Below elbow, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L6940

Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

L6945

Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L6950

Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

L6955

Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L6960

Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

L6965

Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L6970

Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

L6975

Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

L7007 , L7008

Electric hand, switch or myoelectric controlled, adult or pediatric

L7009, L7045

Electric hook, switch or myoelectric controlled, adult or pediatric

L7170

Electronic elbow, hosmer or equal, switch controlled

L7180

Electronic elbow, microprocessor sequential control of elbow and terminal device

L7181

Electronic elbow, microprocessor simultaneous control of elbow and terminal device

L7185

Electronic elbow, adolescent, variety village or equal, switch controlled

L7186

Electronic elbow, child, variety village or equal, switch controlled

L7190 - L7191

Electronic elbow, variety village or equal, myoelectronically controlled, adolescent or child

L7259

Electronic wrist rotator, any type

L7400

Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)

L7401

Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)

L7402

Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)

L7403

Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material

L7404

Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material

L7405

Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material

L7499

Upper extremity prosthesis, not otherwise specified

The services associated with these codes do not require prior authorization:

Codes

Description

L6632

Upper extremity addition, latex suspension sleeve, each

L7360

Six volt battery, each

L7362

Battery charger, six volt, each

L7364

Twelve volt battery, each

L7366

Battery charger, twelve volt, each

L7367

Lithium ion battery, rechargeable, replacement

L7368

Lithium ion battery charger

L7510

Repair of prosthetic device, repair or replace minor parts

L7520

Repair prosthetic device, labor component, per 15 minutes

L8415

Prosthetic sheath, upper limb, each

L8435

Prosthetic sock, multiple ply, upper limb, each

L8465

Prosthetic shrinker, upper limb, each

L8485

Prosthetic sock, single ply, upper limb, each

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy contact Member Services at 952-883-7979 or 1-800-233-9645.

Vendor

  • Items must be received from a contracted prosthetic vendor for in-network benefits to apply.

References

  1. Brenner, C.D. (1992, reprinted 2002). Chapter 8B- Prosthetic Principles. Atlas of Limb Prosthetics. (pp 1-7). Retrieved from http://www.oandplibrary.org/alp/
  2. Carey, S .L., Lura, D. J. , Highsmith, J. (2015) Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review. Journal of Rehabilitation Research and Development (JRRD), 52(3): 247-262.
  3. Centers for Medicare and Medicaid Services, Medicare Benefit Policy Manual, CMS Pub. 100-02, Chap 15, Sec 120 (Rev.1, 10-01-03), available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf
  4. Dealing with Upper Limb Prosthetics (2017, March 7) Retrieved from http://www.cpousa.com/prosthetics/upper-extremity/
  5. Dutta, A. Paulus, W. and Nitsche, M. (2014). Facilitating myoelectric-control with transcranial direct current stimulation: a preliminary study in health humans. Journal of neuroengineering and rehabilitation, 11(13): 1-10.
  6. ECRI Institute. (2010). Myoelectric Upper-extremity Prostheses. Plymouth Meeting, PA: ECRI Institute.
  7. ECRI Institute. (2011). Health Technology Forecast: Advanced Prosthetic Arm Technology. Plymouth Meeting, PA: ECRI Institute.
  8. ECRI Institute. (2011). Health Technology Trends: FDA’s innovation initiative piloting next-generation prosthetic technology. Plymouth Meeting, PA: ECRI Institute.
  9. ECRI Institute. (2016). Technology Forecast- Enhanced-dexterity Prosthetic Arm (LUKE Arm) to Restore Natural Arm Functions after Amputation. Plymouth Meeting, PA: ECRI Institute.
  10. Esquenazi, A. (2004). Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration. Disability and Rehabilitation, 26(14-15): 831-836.
  11. Fryer, C.M. and Michael, J.W. (1992, reprinted 2002). Chapter 6A-Upper-Limb Prosthetics: Body Powered Components. Atlas of Limb Prosthetics. (pp. 1-9). Retrieved from http://www.oandplibrary.org/alp/
  12. Katz, S., Ford, A.B., Moskowitz, R.W., Jackson, B.A., & Jaffe, M.W. (1963). Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185(12), 914-919.
  13. Kistenberg, R. (2014) Prosthetic Choices for People with Leg and Arm Amputations. Physical Medicine and Rehabilitation Clinics of North America, 25(1): 93-115.
  14. Lake, Chris (2009) Experience With Electric Prostheses for the Partial Hand Presentation: An Eight-Year Retrospective. Journal of Prosthetics and Orthotics, 21(2): 125-130.
  15. Motion Control, Inc. (2/2001). Who Is An Appropriate Candidate for a Myoelectric Arm? Retrieved from http://utaharm.com/
  16. Pasquina, P., Evangelista, M., Carvalho, A., Lockhart, J. Griffin, S. Nanos, G., McKay, P. … and Hankin, D. (2015). First-in-Man Demonstration of Fully Implanted Myoelectric Sensors for Control of an Advanced Electromechanical Arm by Transradial Amputees. Journal of Neuroscience Methods, 244:85-93.
  17. Resnik, L. (2011) Development and testing of new upper-limb prosthetic devices: Research designs for usability testing. Journal of Rehabilitative Research & Development, 48(6):697-706.

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Policy activity

  • 02/10/2015 - Date of origin
  • 01/01/2019 - Effective date
Review date
  • 02/2018
Revision date
  • 10/01/2018

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