6 Things You Can Do To Help Your Patient Get an FES Cycle At Home!

As physical therapists, we want to do everything we can to effectively advocate for equipment and services for our patients. And if your patient needs an FES cycle at home, it might seem like a daunting process!

At MYOLYN, we have the better part of a decade’s worth of experience getting MyoCycle FES cycling systems to patients– whether through private pay, insurance reimbursement, grants, fundraising, or through Veterans Affairs or Workers Compensation–we’ve done it all, and we’re happy to help you and your patient every step of the way.

Below we’ve compiled a list of six things you can do to help give your patient the best possible chance to get MyoCycle at home!

1. Write Detailed Daily Notes of FES Cycling Sessions

Your FES cycling session daily notes can help support your patient’s case when submitting to insurance for coverage of an FES cycling home system.

Daily documentation of an FES cycling session should always include basic metrics such as time spent cycling, the muscle groups stimulated and stimulation levels, and average power output.

But it is especially helpful to include your patient’s response to treatment: doing a quick assessment of the patient’s spasticity (e.g. a modified ashworth scale) before and after FES cycling can provide meaningful and objective data that’s hard to refute. Likewise, assessing your patient’s transfer ability or gait before and after FES cycling can demonstrate how the intervention benefits your patient’s function. 

Finally, be sure to get a subjective response from your patient to include in your notes! Did they feel an improvement in their sensation afterwards? Safer while transferring? Increased circulation in their legs? Improved mood? Reduced nighttime spasms and therefore improved sleep quality? Some of these improvements can be difficult to document objectively, so consider the use of the Patient Specific Functional Scale to increase objectivity and strengthen your notes!

In the event you do not have access to an FES cycle at your clinic, it would be helpful to trial an NMES unit on various muscle groups and document your patient’s response. You might even include that you feel the patient would greatly benefit from electrical stimulation at greater intensity/volume/with applied resistance–such as with FES cycling! 

2. Use Progress Notes to Show The Impact of FES

When writing your progress notes, be sure to include how your patient is progressing in their FES cycling sessions– comment on the significance of increasing power output or that tolerance to the stimulation is improving and therefore you’ve been able to drive greater session intensity, etc. As with documenting in your daily notes, be sure to expound on how FES cycling has improved your patient’s function and improved independence and/or reduced their caregiver burden. Elaborate on improvements in their outcome measures and discuss how FES cycling as part of the plan of care has accelerated progress. The more specific, the better! 

An example:

The use of FES cycling within the plan of care has reduced the patient’s spasticity and he is more consistently able to transfer himself to/from bed to chair independently; 4/5 trials this interim versus 2/5 trials during the previous assessment.

3. Include a Customized Letter of Medical Necessity

At MYOLYN, we have a Letter of Medical Necessity (LMN) template and prescription form we will send to your patient’s doctor for signature. These documents, along with your daily and progress notes will be used to substantiate the patient’s insurance submission.  

In order to present the strongest possible case for your patient, we recommend modifying our LMN template to add details regarding your use of FES cycling during therapy sessions and the patient’s response– much like what we recommended in writing daily and progress notes. Describing how the use of FES cycling in the patient’s plan of care has enhanced their recovery, improved their safety and independence, and decreased caregiver burden can demonstrate why an FES cycle for home use is medically necessary to manage the patient’s condition ongoing.

We’ve seen firsthand how clinicians providing these valuable insights and specifics can enhance the patient’s case and increase the likelihood of a successful outcome. Once you’ve modified the LMN, we will send it to the patient’s doctor for signature.

4. Know about Funding Options!

Did you know there are charitable organizations and foundations across the country that offer grants to help patients cover the cost of an FES Cycle? We have quite a few recent success stories where our team has been able to connect eligible patients with grants that have provided partial or full funding for their MyoCycle!

At MYOLYN, we strive to make FES cycling accessible for as many people as possible, so we’ve recently reworked our funding page to make it easy to search for alternative funding sources. Whether your patient lives in a certain geographic area, sustained an injury during an outdoor recreational activity, had a job in the construction trades, etc., chances are we can connect them with a grant which may help them get a MyoCycle at home!

5. Know your patient’s veteran/Worker’s compensation status

Is your patient a veteran? Whether or not their condition is related to their service, we’ve been able to help many veterans get a MyoCycle for home through the VA and other service-oriented foundations.

Was your patient injured as a result of a workplace accident (and therefore covered under Workers Compensation)? Again, we’ve been highly successful in working with patients covered under various WC plans to get MyoCycles for home at no cost to the patient.

6. Let MYOLYN help!

Let us help! Our highly knowledgeable and resourceful team is here to help you and your patient navigate the best path forward to get a MyoCycle at home. You can refer a patient directly on our website or email Deb Ciresi, our Patient Advocate directly and she will be happy to assist. Deb will contact your patient and discuss all their options so they can continue the great work you’ve started with them.