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Permobil Inc
300 Duke Dr
Lebanon, TN 37090
Phone 800-736-0925 | Fax 406.522.8563
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- ABOUT
- BACK SUPPORTS
- Acta-Back
- E2613/E2614
- Acta-Back
- E2615/E2616
- Acta-Back Deep
- E2620/E2621
- Acta-Back Contour
- Acta-Back LTS
- Acta-Relief
- E2615
- Acta-Relief
- E2620/E2621
- Acta-Relief LTS
- Acta-Embrace
- E2613/E2614
- Acta-Embrace
- E2620/E2621
- Acta-Embrace LTS
- General Use
- E2611/E2612
- Elements Back
- Visco Back
- WHEELCHAIR CUSHIONS
- ACCESSORIES
- PEDIATRICS
- QUICK ORDERLOG IN
Diagnosis Search
Find the product best suited to a patient's HCPCS eligibility requirements by answering a few simple questions.
Please choose a cushion or back.
Does the patient have any of the following?
S1: current pressure ulcer
- Decubitus Ulcer, Lower Back (707.03)
- Decubitus Ulcer, Hip (707.04)
- Decubitus Ulcer, Buttock (707.05)
OR past history of a pressure ulcer on seating surface
- Decubitus Ulcer, Lower Back (707.03)
- Decubitus Ulcer, Hip (707.04)
- Decubitus Ulcer, Buttock (707.05)
OR S2: absent or impaired sensation
OR inability to carry out functional weight shift due to one of the following ICD-9 codes:
- Late Effects of Acute Poliomyelitis (138)
- Cerebral Degeneration Usually Manifest in Childhood (330.0-330.9)
- Alzheimer’s Disease (331.0)
- Paralysis Agitans (332.0)
- Anterior Horn Cell Disease (SMA) (335.0-335.21)
- Other Motor Neuron Disease (335.23-335.9)
- Other Diseases of the Spinal Cord (336.0-336.3)
- Multiple Sclerosis (340)
- Other Demyelinating Diseases of CNS (341.0-341.9)
- Infantile Cerebral Palsy (343.0-343.9)
- Quadriplegia, Quadriparesis, Paraplegia (lower limbs) (344.0-344.1)
- Spina Bifida (741.00-741.93)
- Athetoid Cerebra Palsy (333.71)
- Huntington’s Chorea (333.4)
- Idiopathic Torsion Dystonia (333.6)
- Hemiplegia and Hemiparesis (342.00-342.92)(438.20-438.22)
- Arthrogryposis (728.3-754.89)
- Osteogenesis Imperfecta (756.51)
- Spinocerebellar Disease (334.0-334.9)
- Transverse Myelitis (323.82)
Does the patient have any significant asymmetries that are due to one of the ICD-9 codes listed on the criteria “S2”, above, or one of the following ICD-9 codes? additionally, a kx modifier for the k0734 & k0736 codes needs to be included which indicated all necessary documentation to support clinical need is in file.
- Symptomatic Torsion Dystonia (333.7)
- Spinocerebellar Disease (334.0-334.9)
- Other Paralytic Syndromes (Monoplegia of the lower limbs) (344.30-344.32)
- Congenital Hereditary Muscular Dystrophy (359.0)
- Heredity Progressive Muscular Dystrophy (359.1)
- Hemiplegia- Late Effects of CVD (438.20-438.22)
- Monoplegia of Lower Limbs- Late Effects of CVD (438.40-438.42)
Does the patient require individual consideration or have they been denied as not medically necessary?
- Huntington's Chorea (333.4)
- Idiopathic Torsion Dystonia (333.6)
- Symptomatic Torsion Dystonia (333.7)
- Spinocerebellar Disease (334.0-334.9)
- Hemiplegia and Hemiparesis (342.00-342.92)(438.20-438.22)
- Other Paralytic Syndromes (Monoplegia of the lower limbs) (334.30-344.32)
- Congenital Hereditary Muscular Dystrophy (359.0)
- Heredity Progressive Muscular Dystrophy (359.1)
- Hemiplegia- Late Effects of CVD (438.20-438.22)
- Monoplegia of Lower Limbs- Late Effects of CVD (438.40-438.42)
Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2624/E2625:
HCPCS Coding: E2607/E2608:
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Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2622/E2623:
HCPCS Coding: E2622:
HCPCS Coding: E2603/E2604:
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Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2605/E2606:
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Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2601/E2602
Start Over
Does the patient have any significant postural asymmetries that are due to the diagnoses listed below?
- Late Effects of Acute Poliomyelitis (138)
- Cerebral Degeneration Usually Manifest in Childhood (330.0-330.9)
- Alzheimer’s Disease (331.0)
- Paralysis Agitans (332.0)
- Huntington’s Chorea (333.4)
- Idiopathic Torsion Dystonia (333.6)
- Symptomatic Torsion Dystonia (333.7)
- Spinocerebellar Disease (334.0-334.9)
- Anterior Horn Cell Disease (SMA) (335.0-335.21)
- Other Motor Neuron Disease (335.23-335.9)
- Other Diseases of the Spinal Cord (336.0-336.3)
- Multiple Sclerosis (340)
- Other Demyelinating Diseases of CNS (341.0-341.9)
- Hemiplegia and Hemiparesis (342.00-342.92)(438.20-438.22)
- Infantile Cerebral Palsy (343.0-343.9)
- Quadriplegia, Quadriparesis, Paraplegia (lower limbs) (344.0-344.1)
- Other Paralytic Syndromes (Monoplegia of the lower limbs) (344.30-344.32)
- Congenital Hereditary Muscular Dystrophy (359.0)
- Heredity Progressive Muscular Dystrophy (359.1)
- Hemiplegia- Late Effects of CVD (438.20-438.22)
- Spina Bifida (741.00-741.93)
- Traumatic Amputation of Leg (897.2-897.6)
- Osteogenesis Imperfecta (756.51)
Does the patient require individual consideration or have they been denied as not medically necessary?
Does the patient meet the Medicare Coverage criteria for a wheelchair?
Is there a comprehensive written evaluation by a licensed clinician (not an employee or paid by supplier) which clearly demonstrates why prefabricated is insufficient?
Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2613/E2614:
HCPCS Coding: E2615/E2616:
HCPCS Coding: E2615:
HCPCS Coding: E2620/E2621:
Start Over
Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2605/E2606:
Based on your answers, these are the products that would best suit your patient's needs:
HCPCS Coding: E2617:
*Product results only valid for patients who have a wheelchair and meet Medicare coverage criteria for it.