Seat Lifts - DME.SW.109.A

Electric (E0627) and non-electric/battery seat lift mechanisms (E0629) are covered only when the member has a strength/mobility‑impairing condition, cannot stand from any chair in the home but can ambulate/transfer independently once standing, has failed standard treatments (e.g., medications, PT), and can safely use the device; toilet seat lifts (E0172), stair/van/bed lifts and other home‑modification or convenience devices are excluded. Documentation must confirm the diagnosis/functional limitation, inability to stand from any home chair, independent ambulation once standing, failed conservative treatments, safe use of the device, and the specific HCPCS code justification.

"A seat lift mechanism (HCPCS E0627 or E0629) is medically necessary when all of the following apply:"

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