General Use Seat Cushion (E2601, E2602)
General Use Back Cushion (E2611, E2612)

Patient has a manual wheelchair or a power wheelchair with a sling/solid seat/back and the patient meets Medicare criteria for it.

Skin Protection Seat Cushion (E2603, E2604, E2622, E2623)

Patient has a manual wheelchair or a power wheelchair with a sling/solid seat/back and the patient meets Medicare criteria for it.

And,

Any pressure ulcer or past history of a pressure ulcer on the area of contact with seating surface: (707.03, 707.04, 707.05)

Or,

Absent or impaired sensation in the area of contact with the seat surface or inability to carry out a functional weight shift due to one of the following:

Spinal disease resulting in:

• quadraplegia (344.00)
• paraplegia (344.1)
• other spinal cord diseases: (336.0 -336.3)
• multiple sclerosis (340)
• other demyelinating diseases: (341.0 - 341.9)
• cerebral palsy (343.0 - 343.9)
• anterior horn cell diseases including: amyotrophic lateral sclerosis
  (335.0 - 335.21) (335.23 - 335.9)
• Post polio paralysis (138)
• Traumatic brain injury resulting in: Quadriplegia (344.09)
• Spina bifida (741.00 - 741.93)
• Childhood cerebral degeneration (330.0 - 330.9)
• Alzheimer's disease (331.0)
• Parkinson's disease (332.0)
• Muscular dystrophy (359.0 -359.1)
• Hemiplegia (342.00 - 342.92) (438.20 - 438.22)
• Huntington's chorea (333.4)
• Idiopathic torsion dystonia (333.6)
• Athetoid cerebral palsy (333.71)

Positioning Seat Cushion (E2605, E2606)
Positioning Back Cushion (E2613-E2616, E2620, E2621)

Patient has a manual wheelchair or a power wheelchair with a sling/solid seat/back and the patient meets Medicare criteria for it.

And,

Any significant postural asymmetries due to one of the following diagnoses:

Spinal disease resulting in:

• quadraplegia (344.00)
• paraplegia (344.1)
• other spinal cord diseases: (336.0 -336.3)
• multiple sclerosis (340)
• other demyelinating diseases: (341.0 - 341.9)
• cerebral palsy (343.0 - 343.9)
• anterior horn cell diseases including: amyotrophic lateral sclerosis
  (335.0 - 335.21) (335.23 - 335.9)
• Post polio paralysis (138)
• Traumatic brain injury resulting in: Quadriplegia (344.09)
• Spina bifida (741.00 - 741.93)
• Childhood cerebral degeneration (330.0 - 330.9)
• Alzheimer's disease (331.0)
• Parkinson's disease (332.0)
• Muscular dystrophy (359.0 -359.1)
• Hemiplegia (342.00 - 342.92) (438.20 - 438.22)
• Huntington's chorea (333.4)
• Idiopathic torsion dystonia (333.6)
• Athetoid cerebral palsy (333.71)

Or,

• Monoplegia of the lower limb (344.30-344.32; 438.40-438.42) Due to stroke, traumatic brain injury or other etiology
• Spinocerebellar disease (334.0-334.9)
• Above knee leg amputation (897.2-897.7)
• Osteogenesis imperfect (756.51)
• Transverse myelitis (323.82)

Combination Skin Protection/Positioning Seat Cushion (E2607, E2608, K0736, K0737)

Patient meets criteria for both a skin protection seat cushion and a positioning seat cushion.