E0627, Seat lift mechanism, electric, any type
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Documentation Required
- A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted.
- For DMEPOS base items that require a Written Order Prior to Delivery (WOPD), the supplier must have received a signed SWO/WOPD prior to delivery of the item.
- WOPD for base items requiring it must list the base item and may list separately billed associated options, accessories, and supplies prior to delivery.
- Practitioner's medical record must document that appropriate therapeutic modalities (e.g., medication, physical therapy) were tried and failed to enable transfer from a chair to standing.
Key Coverage Criteria
- Beneficiary has severe arthritis of the hip or knee, or has a severe neuromuscular disease.
- Seat lift mechanism is part of the treating practitioner's course of treatment and is prescribed to effect improvement or to arrest/retard deterioration.
- Beneficiary is completely incapable of standing up from a regular armchair or any chair in their home (simple difficulty or inability with low chairs alone is insufficient).
- Once standing, the beneficiary must have the ability to ambulate.
- Covered seat lift mechanisms must operate smoothly, be controllable by the beneficiary, and effectively assist standing up and sitting down without other assistance.
- Practitioner ordering the seat lift must be the treating or consulting practitioner for the disease/condition that necessitates the device.
6 Active Policies
ANTHEM-CG-DME-25, CG-DME-25 Seat Lift Mechanisms
L33801, Seat Lift Mechanisms
AETNA-CPB-0429, Bathroom and Toilet Equipment and Supplies
EVICORE-HPLAN-CIGNA-3C6BF790C032, Cigna Commercial DME Code List - Effective 03/07/2026
EVICORE-HPLAN-CIGNA-1815296EE67F
Related Codes
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