Criteria
Seat lift mechanisms may be considered medically necessary when ALL of the following are met:
- Ordered by the treating physician; and
- Prescribed to effect improvement or to attest or retard deterioration in the individual’s condition; and
- Individual has severe arthritis of the hip or knee or has a moderate neuromuscular disease; and
- Individual is 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.
Coverage of seat lift mechanisms is limited to those types that meet ALL of the following:
- Operates smoothly; and
- Can be controlled by the individual; and
- Effectively assist an individual in standing up and sitting down without other assistance.
Seat lifts that operate by spring release mechanism with a sudden, catapult-like motion and jolt the individual from a seated to a standing position are considered not medically necessary.
Seat lift mechanisms not meeting the criteria as indicated in this policy are considered not medically necessary.
Procedure Codes
