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Coverage criteria policies

Lift Chair Mechanism-Minnesota Health Care Programs

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

Prior authorization is required for seat lift mechanism.

Coverage

A seat lift (lift chair) mechanism is generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

Seat lift mechanisms are covered for recipients who meet all of the following criteria:

  1. The recipient has arthritis of the hip or knee, neuromuscular disease or another medical condition that affects his or her strength or mobility.
  2. The recipient is unable to stand up from a regular armchair at home.
  3. Once standing, the recipient has the ability to ambulate independently or with a properly fitted walker or cane.

Seat lift mechanisms are expected to serve the recipient for at least five years. If a device is stolen or damaged beyond repair, a replacement device may be covered with authorization. Equipment should not be replaced if still usable and meeting the patient’s needs after five years.

Indications that are not covered

The following are not covered:

  1. Seat lift mechanisms that operate by spring release mechanism are not covered because they are not the community standard of care and pose a risk to recipients with limited strength.
  2. Although a seat lift mechanism may be covered, the chair for which the mechanism is intended is not covered because it is furniture rather than medical equipment.

Definitions

A seat lift mechanism is used to allow a person to move from a seated position to a standing position.

If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

The services associated with these codes require prior authorization:

Codes

Description

E0627

Seat lift mechanism, electric, any type

E0629

Seat lift mechanism, non-electric, any type

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

References

  1. Patient Lifts and Seat Lift Mechanisms-MHCP Provider Manual

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Policy activity

  • 06/15/2016 - Date of origin
  • 06/01/2017 - Effective date
Review date
  • 06/2017

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