Anthem Blue Cross Connecticut CG-DME-25 Seat Lift Mechanisms Form


Effective Date

NA

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses seat lift mechanisms, assistive devices used in the home to lift a person’s body from a sitting position to a standing position or to lower the individual from a standing to a sitting position.

This document does not address powered seat elevation systems used for powered wheeled mobility devices (see CG-DME-31).

Note: Please see the following related documents for additional information:

  • CG-DME-10 Durable Medical Equipment
  • CG-DME-23 Lifting Devices for Use in the Home
  • CG-DME-31 Powered Wheeled Mobility Devices

Clinical Indications

Medically Necessary:

A seat lift mechanism is considered medically necessary when all the following criteria are met:

  1. The individual must have severe arthritis of the hip or knee(s) or have a severe neuromuscular disease; and
  2. The seat lift mechanism must be a part of the prescribed course of treatment; and
  3. The individual must be completely incapable of standing up from a regular armchair or any chair in their home; and
  4. Once standing, the individual must have the ability to ambulate.

Note: Documentation that an individual has difficulty or is even incapable of getting up from a chair, particularly a low chair, is insufficient justification for a seat lift mechanism. Most individuals who are capable of ambulating can raise up out of an ordinary chair if the seat height is appropriate and the chair has arms.

Not Medically Necessary:

  1. A seat lift that operates by spring release mechanism with a sudden, catapult-like motion and jolts the individual from a seated to a standing position is considered not medically necessary.
  2. A seat lift mechanism is considered not medically necessary when the criteria listed above are not met.