Seat Lift Mechanisms PDF Print E-mail

1. Description

Seat lift mechanisms are assistive devices used to lift the body from a sitting position to a standing position. The seat lift mechanism is also capable of lowering the individual from a standing to a sitting position.

2. Clinical Indications

2.1. Medically Necessary:

A seat lift mechanism is considered medically necessary when all the following criteria are met:

  • The individual must have severe arthritis of the hip or knee(s) or have a severe neuromuscular disease; and
  • The seat lift mechanism must be a part of the physician's course of treatment and be prescribed to effect improvement or arrest or retard deterioration in the individual's condition; and
  • The individual must be completely incapable of standing up from a regular armchair or any chair in their home; and
  • Once standing, the individual must have the ability to ambulate.

Note: Documentation that an individual has difficulty or is even incapable of getting up from a chair, particularly a low chair, is insufficient justification for a seat lift mechanism. Most individuals who are capable of ambulating can raise up out of an ordinary chair if the seat height is appropriate and the chair has arms.

2.2. Not Medically Necessary:

A seat lift that operates by spring release mechanism with a sudden, catapult-like motion and jolts the individual from a seated to a standing position is considered not medically necessary.

A seat lift mechanism is considered not medically necessary when the criteria listed above are not met.

3. Discussion/General Information

Individuals with impaired mobility often require physical assistance in lifting and transferring. Numerous medical conditions (e.g., arthritis, muscular dystrophy, neuromuscular diseases) can lead to limited mobility as a result of pain, joint stiffness or muscle weakness. Individuals are often not able to move from a sitting position to a standing position without the assistance of another person or a device. Devices such as seat lift mechanisms have been employed to ease transfers and prevent patient and/or caregiver injuries (CMS, 2005). These devices are utilized in the individual's home or place of residence. In establishing medical necessity for the seat lift, CMS states the seat lift must be included in the physician's course of treatment, that it is likely to effect improvement or arrest or retard deterioration in the patient's condition, and that the severity of the condition is such that the alternative would be chair or bed confinement (CMS, 2008).

4. Coding

The following codes for treatments and procedures applicable to this document are included below for informational purposes.  Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy.  Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member.

HCPCS
E0170 Commode chair with integrated seat lift mechanism, electric, any type
E0171 Commode chair with integrated seat lift mechanism, non-electric, any type
E0172 Seat lift mechanism placed over or on top of toilet, any type
E0627 Seat lift mechanism incorporated into a combination lift-chair mechanism
E0628 Separate seat lift mechanism for use with patient owned furniture; electric
E0629 Separate seat lift mechanism for use with patient owned furniture; non-electric
ICD-9 Diagnosis
Including, but not limited to, the following
358.00-358.9 Myoneural disorders
359.0-359.9 Muscular dystrophies and other myopathies
715.00-715.98 Osteoarthrosis and allied disorders
716.00-716.99 Other and unspecified arthropathies
719.45-719.49 Pain in joint

 

 

Add comment


Security code
Refresh