Patient Lifts PDF Print E-mail

1. Description

A patient lift is a device used to assist the caregiver(s) in transferring an individual from bed to chair and back or other locations when the individual is unable to assist with the transfer. This document addresses patient lifts, including the multi-positional patient transfer system.

2. Clinical Indications

Medically Necessary:

A hydraulic/mechanical patient lift is considered medically necessary for an individual when all of the following criteria are met:

  • when it is used for the transfer of the individual between a bed and a chair, wheelchair, commode, or shower/bath chair; and
  • when transfers cannot be performed independently and require the assistance of more than one person, and
  • when the individual would be bed confined without the use of a lift; and
  • when the individual's condition is such that periodic movement is necessary to improve his/her condition or to arrest/retard deterioration of their condition.

A canvas or nylon sling or seat for a hydraulic/mechanical patient lift is considered medically necessary as an accessory when ordered as a replacement for the original equipment item and the criteria listed above are met.

A multi-positional patient transfer system is considered medically necessary in lieu of any of the following mobility assistive equipment, including but not limited to canes, crutches, walkers, rollabout chairs, transfer chairs, manual wheelchairs, power-operated vehicles, or power wheelchairs, when both of the following criteria are met:

  • the criteria for a hydraulic/mechanical patient lift are met; and
  • the individual requires supine positioning for transfers.

Not Medically Necessary:

A hydraulic/mechanical patient lift or multi-positional patient transfer system is considered not medically necessary when the criteria listed above are not met.

An electric lift mechanism is considered not medically necessary.

3. Discussion/General Information

A patient lift is a device used within the home or place of residence to assist the caregiver(s) in transferring an individual between a bed and a chair, wheelchair, commode, or shower/bath chair and back when the individual is unable to assist with the transfer. A multi-positional patient transfer system is used to assist the caregiver(s) in transferring an individual who requires the use of a lift along with supine positioning for transfer. Multi-positional transfer systems (e.g. Barton Convertible™ H-250 Chair, Barton™ Medical Corporation, Austin TX) are intended to facilitate an independent and safe transfer for the caregiver and individuals that have medical conditions that precludes the use of a standard transfer device (i.e. hydraulic/mechanical lift).

The medical necessity of a patient lift is based on an evaluation of the individual's needs and capabilities in relation to the following components of the definition of medical necessity:

  1. The lift is clinically appropriate for the diagnosis or treatment of the individual's illness or injury or to improve the functioning of a malformed body member; and
  2. The lift is not primarily for the convenience of the individual, caregiver, physician or other healthcare provider (NGS, 2009).

An electric lift mechanism is considered not medically necessary as an alternative lift mechanism as it is at least as likely to produce equivalent therapeutic results for the treatment of an individual's illness, injury or disease.

The following types of lifts and accessories are considered self-help or convenience items and do not meet the definition of durable medical equipment:

  • van or car lifts (used to lift wheelchair into a truck or van);
  • wheelchair lifts or ramps (e.g., Wheel-O-Vator lift, National Wheel-O-Vator Co., Inc., Roanoke, IL [ThyssenKrupp Access, Grandview, MO]) (provides vertical lift access to stairways or platform ramps for cars/ trunks);
  • ceiling lifts, platform lifts, porch lifts, stair lifts, stairway elevators, and other lifts (electric/motorized or non-motorized), addressing accessibility limitations of a home;
  • home modifications associated with installation of a lift or access within a home.

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
E0621 Sling or seat, patient lift, canvas or nylon
E0625 Patient lift, bathroom or toilet, not otherwise classified
E0630 Patient lift; hydraulic or mechanical, includes any seat, sling strap(s) or pad(s)
E0635 Patient lift; electric, with seat or sling
E0636 Multipositional patient support system, with integrated lift, patient accessible controls
E0637 Combination sit to stand system, any size including pediatric, with seatlift feature, with or without wheels [when used as a lift or transfer system]
E0639 Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories
E0640 Patient lift, fixed system, includes all components/accessories
E1035 Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs
E1036 Multi-positional patient transfer system, extra-wide, with integrated seat, operated by care giver, patient weight capacity greater than 300 lbs
ICD-9 Diagnosis
All diagnoses
 

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Good descriptive and helpful post for all the needful patients. :lol:
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