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E2622 |
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Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth
| short | Adj skin pro w/c cus wd<22in |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment |
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E2623 |
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Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
| short | Adj skin pro wc cus wd>=22in |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment |
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E2624 |
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Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth
| short | Adj skin pro/pos cus<22in |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment |
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E2625 |
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Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
| short | Adj skin pro/pos wc cus>=22 |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment |
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