Skin Protection Wheelchair Cushion - DME.WC.102.A

Covered: skin protection wheelchair cushions (HCPCS E2603, E2604, E2622, E2523) are allowed; cushions are excluded if the patient does not meet the wheelchair prerequisite or lacks the listed clinical indications. Key requirements: patient must have a manual or power wheelchair with a sling/solid seat/back and meet basic wheelchair coverage criteria, with documentation of a current or prior pressure ulcer in the seating contact area, absent/impaired sensation there, or inability to perform a functional weight shift.

"Current pressure ulcer in the area of contact with the seating surface."

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