Effective August 15, 2022, Independence Blue Cross (Independence) and Independence Administrators have updated their medical policy on wheelchair cushions and seating for both Commercial and Medicare Advantage members.
The following changes have been made for Independence and Independence Administrators Commercial members:
Face-to-face requirement language has been added for the following HCPCS codes:
- E2613: Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware
- E2614: Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
- E2616: Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware
- E2620: Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware
- E2621: Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware
The following medically necessary criteria have been added to this policy:
- General use cushion for power wheelchairs
- Captain's Chair for power wheelchairs
The following changes have been made for Independence Medicare Advantage members:
In accordance with Medicare, face-to-face requirement language has been added, per CMS Final Rule, for the following HCPCS codes:
- E2613: Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware
- E2614: Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
- E2616: Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware
- E2620: Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware
- E2621: Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware
Commercial and Medicare Advantage Policy Notifications were posted on July 15, 2022.
For more information, view the following Independence medical policies: