Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

E2601 - E2621  Wheelchair - Cushions

E2601
General use wheelchair seat cushion, width less than 22 inches, any depth
shortGen w/c cushion wdth < 22 in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2602
General use wheelchair seat cushion, width 22 inches or greater, any depth
shortGen w/c cushion wdth >=22 in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2603
Skin protection wheelchair seat cushion, width less than 22 inches, any depth
shortSkin protect wc cus wd <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2604
Skin protection wheelchair seat cushion, width 22 inches or greater, any depth
shortSkin protect wc cus wd>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2605
Positioning wheelchair seat cushion, width less than 22 inches, any depth
shortPosition wc cush wdth <22 in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2606
Positioning wheelchair seat cushion, width 22 inches or greater, any depth
shortPosition wc cush wdth>=22 in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2607
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth
shortSkin pro/pos wc cus wd <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2608
Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth
shortSkin pro/pos wc cus wd>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2609
Custom fabricated wheelchair seat cushion, any size
shortCustom fabricate w/c cushion
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2610
Wheelchair seat cushion, powered
shortPowered w/c cushion
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
E2611
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware
shortGen use back cush wdth <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2612
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware
shortGen use back cush wdth>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2613
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware
shortPosition back cush wd <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2614
Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
shortPosition back cush wd>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2615
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware
shortPos back post/lat wdth <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2616
Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware
shortPos back post/lat wdth>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2617
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware
shortCustom fab w/c back cushion
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2619
Replacement cover for wheelchair seat cushion or back cushion, each
shortReplace cover w/c seat cush
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.02 Date of Service Edit: PolicyNature of Equipment
E2620
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware
shortWc planar back cush wd <22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E2621
Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware
shortWc planar back cush wd>=22in
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment