Item Brochure

E2601 E2602 E2603 E2604 E2605 E2606 E2607 E2608 E2622 E2623
General Use Wheelchair Seat
Cushion,
Width Less Than 22", Any
Depth
General Use Wheelchair
Seat Cushion, Width 22" or
Greater, Any Depth
Skin Protection Wheelchair
Seat Cushion, Width Less
Than 22", Any Depth
Skin Protection Wheelchair
Seat Cushion, Width 22" or
Greater, Any Depth
Positioning Wheelchair Seat
Cushion, Width Less Than
22", Any Depth
Positioning Wheelchair
Seat Cushion, Width 22" or
Greater, Any Depth
Skin Protection & Positioning
Wheelchair Seat Cushion,
Width Less Than 22", Any
Depth
Skin Protection & Positioning
Wheelchair Seat Cushion,
Width 22" or Greater, Any
Depth
Adjustable Skin Protection
Wheelchair Seat Cushion,
Width Less Than 22", Any
Depth
Adjustable Skin Protection
Wheelchair Seat Cushion,
Width 22" or Greater, Any
Depth
Not Specified Not Specified Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Amyotrophic Lateral
Sclerosis, Post Polio,
Traumatic Brain Injury, Spina
Bifida, Childhood Cerebral
Degeneration, Alzheimer's
Disease, Parkinson's Disease,
Hemiplegia, Huntington’s
chorea, Idiopathic torsion
dystonia, Athetoid Cerebral
Palsy, Transverse myelitis
Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Amyotrophic Lateral
Sclerosis, Post Polio,
Traumatic Brain Injury, Spina
Bifida, Childhood Cerebral
Degeneration, Alzheimer's
Disease, Parkinson's Disease,
Hemiplegia, Huntington’s
chorea, Idiopathic torsion
dystonia, Athetoid Cerebral
Palsy, Transverse myelitis
Spinal Cord Injury (paraple-
gia, quadriplegia), Cerebral
Palsy, Paralysis, Post Polio,
Amyotrophic Lateral Sclerosis,
Monoplegia of Lower Limb,
Hemiplegia, Muscular
Dystrophy, Alzheimer’s
Disease, Spina Bifida,
Multiple Sclerosis, Traumatic
amputation of leg(s),
Osteogenesis imperfecta,
Transverse myelitis
Spinal Cord Injury (paraple-
gia, quadriplegia), Cerebral
Palsy, Paralysis, Post
Polio, Amyotrophic Lateral
Sclerosis, Monoplegia of
Lower Limb, Hemiplegia,
Muscular Dystrophy,
Alzheimer’s Disease, Spina
Bifida, Multiple Sclerosis,
Traumatic amputation of
leg(s), Osteogenesis imper-
fecta, Transverse myelitis
Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Post Polio, Traumatic
Brain Injury, Spina Bifida,
Amyotrophic Lateral
Sclerosis, Alzheimer's
Disease, Parkinson's Disease,
†
Monoplegia of Lower Limb,
†
Hemiplegia,
†
Muscular Dystrophy
Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Post Polio, Traumatic
Brain Injury, Spina Bifida,
Amyotrophic Lateral
Sclerosis, Alzheimer's
Disease, Parkinson's Disease,
†
Monoplegia of Lower Limb,
†
Hemiplegia,
†
Muscular Dystrophy
Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Amyotrophic Lateral
Sclerosis, Post Polio,
Traumatic Brain Injury, Spina
Bifida, Childhood Cerebral
Degeneration, Alzheimer's
Disease, Parkinson's Disease,
Hemiplegia, Huntington’s
chorea, Idiopathic torsion
dystonia, Athetoid Cerebral
Palsy, Transverse myelitis
Spinal Cord Injury (paraple-
gia, quadriplegia), Other
Spinal Cord Disease,
Multiple Sclerosis, Cerebral
Palsy, Amyotrophic Lateral
Sclerosis, Post Polio,
Traumatic Brain Injury, Spina
Bifida, Childhood Cerebral
Degeneration, Alzheimer's
Disease, Parkinson's Disease,
Hemiplegia, Huntington’s
chorea, Idiopathic torsion
dystonia, Athetoid Cerebral
Palsy, Transverse myelitis
Invacare
®
Absolute
™
Cushion
Invacare
®
Single Density
Cushion
Invacare
®
Comfort-Mate
Extra Cushion
Invacare
®
Comfort-Mate
Extra Cushion
Invacare
®
Matrx
®
Stabilite
™
Cushion
Invacare
®
Matrx
®
Stabilite
™
Cushion
Invacare
®
Matrx
®
Flovair
™
Gentle/Max Contour Cushion
Invacare
®
Matrx
®
Flovair
™
Gentle/Max Contour Cushion
Invacare
®
Matrx
®
Flo-tech
™
Cushion
Invacare
®
Matrx
®
Flo-tech
™
Cushion
Invacare
®
Single Density
Cushion
Invacare
®
Matrx
®
PS
Cushion
Invacare
®
Matrx
®
PS
Cushion
Invacare
®
Matrx
®
Vi
Cushion
Invacare
®
Matrx
®
Vi
Cushion
SEATING SERIES
* Providers are responsible for determining the appropriate billing codes when submitting claims to the Medicare Program and should consult an attorney or other advisor to discuss specific situations in further detail. This information is subject to change without notice.
†
Qualifying diagnosis code requires additional provision for decubitis ulcer (707.03, 707.04, 707.05)
© 2012 Invacare Corporation. All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications are subject to change without notification. Form # 10-106 Rev. 12/12 120235
HCPCS
Codes
Description
Qualifying DiagnosisAvailable Products
Available Products
HCPCS
Codes
Description
Qualifying
Diagnosis
E2611
General Use Wheelchair Back Cushion, Width Less Than 22",
Any Height, Including Any Type Mounting Hardware
Not Specified
E2612
General Use Wheelchair Back
Cushion, Width 22" or Greater,
Any Height, Including Any Type
Mounting Hardware
Not Specified
E2615
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width
Less Than 22", Any Height, Including Any Type Mounting
Hardware
Spinal Cord Injury (paraplegia, quadriplegia), Cerebral
Palsy, Paralysis, Post Polio, Amyotrophic Lateral Sclerosis,
Monoplegia of Lower Limb, Hemiplegia, Muscular
Dystrophy, Alzheimer’s Disease, Spina Bifida, Multiple
Sclerosis, Traumatic amputation of legs(s) (complete/par-
tial), Osteogenesis imperfecta, Transverse myelitis
E2616
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width
22" or Greater, Any Height, Including Any Type Mounting
Hardware
Spinal Cord Injury (paraplegia, quadriplegia), Cerebral
Palsy, Paralysis, Post Polio, Amyotrophic Lateral Sclerosis,
Monoplegia of Lower Limb, Hemiplegia, Muscular
Dystrophy, Alzheimer’s Disease, Spina Bifida, Multiple
Sclerosis, Traumatic amputation of legs(s) (complete/par-
tial), Osteogenesis imperfecta, Transverse myelitis
Invacare
®
Matrx
®
Genera
™
Back
Invacare
®
Matrx
®
MX1 Back
Invacare
®
Matrx
®
PB/ PB Deep Back
Invacare
®
Matrx
®
PB/ PB Deep Back Invacare
®
Matrx
®
Elite Back
Invacare
®
Matrx
®
Elite Deep Back
2
INVACARE
®
MATRX
®
SEATING SERIES
TABLE OF CONTENTS
Invacare
®
Matrx
®
Back Supports
Invacare
®
Matrx
®
MX1 Back E2615 04
Invacare
®
Matrx
®
Elite Back E2620 06
Invacare
®
Matrx
®
Elite Deep Back E2620 08
Invacare
®
Matrx
®
PB Back E2615/E2616 10
Invacare
®
Matrx
®
PB Deep Back E2615/E2616 12
Invacare
®
Matrx
®
Easy Set Hardware 14
Invacare
®
Matrx
®
Back Specifications 16
Invacare
®
Matrx
®
Seat Cushions
Invacare
®
Matrx
®
Vi Cushion E2607/E2608 18
Invacare
®
Matrx
®
Kid*ab*ra Vi Cushion E2607 19
Invacare
®
Matrx
®
Flovair
™
Cushion E2607/E2608 20
Invacare
®
Matrx
®
PS Cushion E2605/E2606 22
Invacare
®
Matrx
®
Stabilite
™
Cushion E2605/E2606 24
Invacare
®
Matrx
®
Flo-tech
™
Cushion E2622/E2623 26
Invacare
®
Matrx
®
Cushion Specifications 28
Invacare
®
Matrx
®
General Use Back Supports, Seat Cushions and Accessories
Invacare
®
Absolute
™
Cushion E2601 30
Invacare
®
Single Density Cushion E2601/E2602 30
Invacare
®
Comfort-Mate Extra Cushion E2603/E2604 30
Invacare
®
Versair
™
Back E2611/E2612 31
Invacare
®
Matrx
®
Genera Back E2611 31
Invacare
®
Matrx
®
Accessories 32
INVACARE
®
MATRX
®
SEATING
SERIES
E2620
Positioning Wheelchair Back Cushion, Planar with Lateral Supports,
Width Less Than 22", Any Height, Including Any Type Mounting
Hardware
Spinal Cord Injury (paraplegia, quadriplegia), Cerebral Palsy,
Paralysis, Post Polio, Amyotrophic Lateral Sclerosis, Monoplegia
of Lower Limb, Hemiplegia, Muscular Dystrophy, Alzheimer’s
Disease, Spina Bifida, Multiple Sclerosis, Traumatic amputa-
tion of legs(s) (complete/partial), Osteogenesis imperfecta,
Transverse myelitis
Invacare
®
Versair
™
Back Invacare
®
Versair
™
Back