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After conducting an evaluation and understanding a client's needs, selecting the most appropriate cushion can be challenging. The goal of this article is to not only assist in determining seat cushion coverage criteria, but to identify common client characteristics and differentiate between the Sunrise Medical seat cushions that fall into each of the seven main categories. This will aid in making better informed choices for appropriate application of each seat cushion along with justification.
This resource guide is a comprehensive list of the seat cushions that Sunrise Medical offers in all Medicare HCPC seat cushion categories broken down by category. It includes client characteristics for each category and is further broken down by specific cushion characteristics. The cushions are described by their bases and the support they provide; special characteristics such as having air, Flow Fluid, or foam layering systems to optimize pressure relief; cover options; and other features such as JAY CryoFluid to optimize microclimate.
Other insurance companies may follow these guidelines. However, please refer to their specific policies for further details.
General Use
E2601 (width less than 22") / E2602 (width 22" or greater)
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair with sling/solid seat/back. There are no requirements for a specified Diagnosis in the ICD-10 Code.
Client Characteristics
- Clients needing comfort with minimal postural support
- Intact skin integrity or low risk of skin breakdown or shear
- Independent weight shifts and repositioning
- Ideal for intermittent wheelchair users
JAY Basic
- Base: Mildly contoured 2" soft foam. Beveled bottom reduces the "hammocking" effect of upholstery, keeping the wheelchair seating surface level for improved pelvic alignment over time.
- Cover: Moisture-resistant cover with a non-slip bottom to keep the cushion in place during transfers.
- Weight Capacity: 250 lbs., 330 lbs. (22-24" widths)
Non-Adjustable Skin Protection
E2603 (width less than 22") / E2604 (width 22" or greater)
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND a, b, or c are met:
- Has a current or past history of a pressure ulcer in the area of contact with the seating surface (Diagnosis in Group 1 code)
- Presents with absent/impaired sensation (Diagnosis in Group 2 code)
- Has inability to carry out a functional weight shift (Diagnosis in Group 2 code)
Client Characteristics
- May be at low risk of skin breakdown
- May require comfortable seating surface for symmetrical alignment
- May require mild stability for postural support
- May be in a wheelchair for limited periods of time
JAY GO
- Base: Mildly contoured, dual layer foam to provide a stable base and with a soft top layer for comfort
- Cover: Dartex moisture-resistant cover
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
Positioning
E2605 (width less than 22") / E2606 (width 22" or greater)
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND has significant postural asymmetries (a or b):
- Diagnosis in Group 2 Code
- Diagnosis in Group 3 Code)
Client Characteristics
- May be at low risk of skin breakdown
- Provides mild positioning support at the pelvis and thighs to improve pelvic alignment
- May increase sitting tolerance with a more comfortable seating surface
- May be in a wheelchair for limited periods of time
JAY Soft Combi P
- Base: Moderately contoured, high resiliency coated foam (water resistant) base
- Cover: Moisture-resistant cover with non-slip bottom
- Weight Capacity: 250 lbs., 330 lbs. (22-24" widths)
Non-Adjustable Skin Protection and Positioning
E2607 (width less than 22") / E2608 (width 22" or greater)
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND a, b, OR c (Skin Protection) AND d (Positioning) are needed:
- Has a history of/or a current pressure injury on area in contact with seating surface (Diagnosis in Group 1 code)
- Presents with absent/impaired sensation (Diagnosis in Group 2 code)
- Has inability to carry out a functional weight shift (Diagnosis in Group 2 code)
AND
- Has significant postural asymmetries (Diagnosis in Group 2 and 3 codes)
Client Characteristics
- Moderate to high risk for skin breakdown (may have protruding bony prominence on sitting surface, may have impaired or absent sensation, muscles may be getting weaker, skin is aging, has poor nutrition, has some orthopedic deformities)
- May be unable to perform functional weight shifts (skin protection feature provides pressure distribution and shear reduction)
- May have moderate positioning needs
- May require a comfortable seating surface to increase seated tolerance
- May be in a wheelchair for extended periods (uses a wheelchair for their primary way of getting around)
JAY Zip
- Designed for pediatric clients (1.2 lbs., available in 8" width/depth, 2.75" height)
- Base: Soft foam base with optimized firmness by cushion width, soft, Visco memory foam top layer
- Cover: Standard with 1 inner (water resistant) and 2 outer covers (4-way Stretch material with anti-microbial Ionic+)
- Weight Capacity: 165 lbs.
JAY Ion
- Base: Multi-layered foam with varying firmness depending on size, soft Visco memory foam top
- Cover: Standard with 1 inner (water resistant) and outer covers (4-way Stretch material with anti-microbial Ionic+)
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY Union
- Base: Multi-layered foam with JAY Flow Fluid tripad in the pelvic loading area, gel-infused Visco memory foam top layer, moderately contoured with additional lateral & pelvic support.
- Cover: Standard with 1 inner (water resistant) and outer covers (4-way Stretch material with anti-microbial Ionic+)
- Available in standard 4.5" cushion height or reduced profile 3.5"
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY Easy
- Base: Moderately pre-contoured, high-resiliency foam base with a JAY Flow Fluid tripad insert
- Cover: Moisture-resistant cover with non-slip bottom.
- Available in a flat or curved bottom to reduce the "hammocking" effect of sling upholstery.
- Weight Capacity: 330 lbs.
Ride Forward
- Base: Visco-elastic foam over polyurethane foam base surrounds the pelvis with anatomically correct contours while reducing pressure around at-risk bony prominences. The seated interface is immersion / envelopment.
- Cover: Inner polyester fabric with urethane moisture-protecting backing, outer lightweight breathable polyester spacer mesh fabric.
- Optional Ride CAM Wedges added to promote a more upright posture and decrease ischial pressure or asymmetrically to help level a flexible pelvic obliquity.
- Weight Capacity: 350 lbs.
Adjustable Skin Protection
E2622 (width less than 22") / E2623 (width 22" or greater)
The adjustment may be in the manner of direct addition or removal of the fluid (e.g., add or remove air) or indirectly by addition or removal of packets of fluid.
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND a, b, or c are met:
- Has a current or past history of a pressure ulcer in the area of contact with the seating surface (Diagnosis in Group 1 code)
- Presents with absent/impaired sensation (Diagnosis in Group 2 code)
- Has inability to carry out a functional weight shift (Diagnosis in Group 2 code)
Client Characteristics
- May be at high risk of skin breakdown
- Changing positioning needs due to weight loss/gain, change in tone, etc., requiring enhanced skin protection
- May not be able to perform independent weight shifts
- May have moderate positioning needs
- May be in a wheelchair for extended periods of time
JAY Fusion
- Base: Pre-contoured closed cell foam base with a high resiliency foam top layer.
- Optional inserts include JAY Flow Fluid tripad, Air (single or dual valve), JAY Cryo Fluid
- JAY CryoFluid offers optimal skin protection addressing pressure, shear, temperature, and moisture.
- Available in a standard height of 4" or a reduced profile 3".
- Cover: Standard with inner (water resistant) and outer cover (4-way stretch material with anti-microbial Ionic+. Inner layer of spacer fabric helps to promote airflow).
- Weight Capacity: 330 lbs., 500 lbs. (22-24" width)
JAY J2
- Base: Pre-contoured closed-cell foam provides lateral and forward stability. Has a JAY Flow Fluid tripad which consistently ensures proper fluid placement by reducing fluid migration.
- 2.5" overall cushion height with 2" deep pelvic loading area
- Cover: Stretch, 3DX, or incontinence outer cover options.
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY J2 Deep Contour
- Base: Pre-contoured closed cell foam with a JAY Flow Fluid tripad with increased fluid volume
- 4.5" overall cushion height with 3" deep pelvic loading area
- For individuals requiring greater immersion and increased skin protection
- Cover: Stretch, 3DX, or incontinence outer cover options
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY X2
- E2622 Only
- Base: Non-contoured high resiliency foam which allows forward sitting and enhances independence during ADLs for active users
- JAY Flow Fluid tripad and rear coccyx notch which reduces peak pressure and reduces the risk of skin breakdown during movement
- 2.25" cushion height
- Cover: Standard with 1 inner (water resistant) and 4-way stretch outer cover
- Weight Capacity: 330 lbs.
JAY GS
- E2622 Only
- Base: Incorporates a highly durable, stable closed cell foam base and JAY Flow Fluid compartmentalized pad with the unique ability to grow with the client while maintaining skin protection
- Features adjustable well placement using included shelf extension
- Standard contracture cutouts
- Built-in growth for pediatric clients
- Cover: 4-way stretch with anti-microbial Ionic+. Inner layer of spacer fabric helps to promote airflow.
- Weight Capacity: 330 lbs.
JAY Syncra
- Exclusive to QUICKIE power wheelchairs with SEDEO PRO & PRO Advanced seating (Q300 M, Q500 M, Q700 M, Q700-UP M).
- Includes a lowered rear pelvic wall and deeper leg troughs, cradling the pelvis and thighs to improve alignment and prevent sliding during power recline
- JAY CryoFluid comes standard. Also available with air insert (single or dual).
- 4.5" overall cushion height with 3" deep pelvic loading area
- Cover: Premium Leatherette or 4-Way stretch cover options with leatherette side bands on all covers
- Weight Capacity: 300 lbs., 500 lbs. (22" widths)
Adjustable Skin Protection and Positioning
E2624 (width less than 22") / E2625 (width 22" or greater)
An adjustable skin protection and positioning seat cushion (E2624/E2625) has all the characteristics of an E2607/E2608 cushion and is determined to be adjustable by the PDAC. The adjustability feature only relates to the skin protection properties of the cushion. The adjustment may be in the manner of direct addition or removal of the fluid (i.e., add or remove air) or indirectly by addition or removal of packets of fluid.
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND a, b, OR c (Skin Protection) AND d (Positioning) are needed:
- Has a current or past history of a pressure ulcer in the area of contact with seating surface (Diagnosis in Group 1 code)
- Presents with absent/impaired sensation (Diagnosis in Group 2 code)
- Has inability to carry out a functional weight shift (Diagnosis in Group 2 code)
AND
- Has significant postural asymmetries (Diagnosis in Group 2 and 3 codes)
Client Characteristics
- May be at high risk of skin breakdown
- May be unable to perform functional weight shifts
- May have moderate positioning needs due to postural asymmetries (reducible/non-reducible)
- May be in a wheelchair for extended periods of time
- May experience weight loss
JAY Fusion with Positioning
- Base: Pre-contoured closed cell foam base with a high resiliency foam top layer
- Optional inserts include JAY Flow Fluid tripad, Air (single or dual valve), JAY CryoFluid
- JAY CryoFluid offers optimal skin protection addressing pressure, shear, temperature, and moisture
- Available in standard height of 4" or a reduced profile 3"
- Positioning supports include a pair of 1" adductors/lateral supports, pair of 1" hip guides, and a 1" medial thigh support
- Cover: Standard with inner (water resistant) and outer cover (4-way Stretch material with anti-microbial Ionic+. Inner layer of spacer fabric helps to promote airflow.)
- Weight Capacity: 330 lbs., 500 lbs. (22-24" width)
JAY J2 with Positioning
- Base: Pre-contoured closed-cell foam provides lateral and forward stability. JAY Flow Fluid tripad which consistently ensures proper fluid placement by reducing fluid migration
- 2.5" overall cushion height with 2" deep pelvic loading area
- Positioning supports include a pair of 1" lateral thigh supports
- Cover: Stretch, 3DX, or incontinence outer cover options
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY J2 Deep Contour with Positioning
- Base: Pre-contoured closed cell foam with a JAY Flow Fluid tripad with increased fluid volume
- 4.5" overall cushion height with 3" deep pelvic loading area
- For individuals requiring greater immersion and increased skin protection and stability
- Positioning supports include a pair of 1" lateral thigh supports
- Cover: Stretch, 3DX, or incontinence outer cover options
- Weight Capacity: 330 lbs., 500 lbs. (22-24" widths)
JAY GS with Positioning
- E2624 Only
- Base: Incorporates a highly durable, stable closed cell foam base and JAY Flow Fluid compartmentalized pad with the unique ability to grow with the client
- Features adjustable well placement using included shelf extension
- Available in two positioning versions: 2" or 3"
- Positioning supports include a pair of pelvic lateral thigh supports and a medial thigh support with standard contracture cutouts
- Highly durable and can be easily modified in the field
- Built-ingrowth for pediatric clients
- Cover: 4-way stretch material with anti-microbial Ionic+ inner layer of spacer fabric helps to promote airflow
- Weight Capacity: 330 lbs.
Ride Java
- E2624 Only
- Base: Pre-contoured firm closed-cell foam base, with soft open-cell foam overlay covered with ventilated Polyether TPU Film, assists to redistribute the forces of pressure and shear away from high-risk areas, while selectively applying the forces to areas more tolerant. Vented and contoured shape assists to keep skin cool and dry. The seating interface is offloading.
- Cover: Lightweight breathable spandex and polyester spacer mesh fabric
- Optional Ride CAM Wedges added to promote a more upright posture and decrease ischial pressure or asymmetrically to help level a flexible pelvic obliquity.
- Weight Capacity: 350 lbs.
Custom
E2609 (any size)
Medicare Coverage Criteria1
Individual qualifies for a manual or power wheelchair AND a, AND b, c (Skin Protection) OR d (Positioning) are needed:
- Written comprehensive evaluation by a licensed/certified medical professional, such as PT or OT stating why a pre-fabricated cushion is insufficient
- Has a current or past history of a pressure ulcer in the area of contact with the seating surface (Diagnosis in Group 1 code)
- Presents with absent/impaired sensation or inability to carry out functional weight shift (Diagnosis in Group 2 code)
- Has significant postural asymmetries (Diagnosis in Group 2 or 3 codes)
Client Characteristics
- May be at high risk of skin injury, have current skin injury, or have past history of having a skin injury
- May have positioning needs due to significant postural asymmetries/tendencies (reducible/non-reducible)
- Has absent/impaired sensation
- May have an inability to carry out functional weight shift
- May be in a wheelchair for extended periods of time
JAY SureFit
- Made-to-order seating solution: cushion is fabricated to specific client measurements and is available in a variety of options and colors
- Can specialize cushion to include modifications such as anti-thrust, split seat, leg length difference, built-in obliquity modifications, built-in medial and lateral supports, and more.
- WC-20 Transit tested and approved when combined with a QUICKIE or ZIPPIE WC-19 Transit-compliant mobility base.
- Able to be bundled with QUICKIE or ZIPPIE wheelchair frames, so both products can be built and tested for compatibility before shipping
- Made to order with an online configurator
- Cover: Outer cover is available in Vinyl, Stretch, Cordura, Nylon, or 3DX material
- Weight Capacity:
250 lbs. (non-transit)
300 lbs. (non-transit-HD)
200 lbs. (Transit: minimum 48 lbs.)
JAY Fit
- Semi-personalized seating includes multiple sizes and various well insert types. Includes foam options for all layers of cushion foam, and optional lateral and anterior well reducers, adjustable lateral pelvic supports, and adjustable lateral thigh support.
- Cover: 3DX with Black stretch or Reverse Dartex options
- Weight Capacity: 250 lbs.
Ride Custom AccuSoft
- Base: Custom contoured shape with a softer, more forgiving sitting surface made of polyurethane foam
- Options to contour to reduce forces at high-risk areas and provide slightly greater forces at low-risk areas
- Full contact option surrounds the pelvis with supportive contours distributing pressures throughout the seating surface
- Seating interface is immersion / envelopment. Available in soft and extra soft foam
- Cover: Inner wipeable polyester fabric with a polyurethane coating, lightweight breathable polyester spacer mesh fabric with optional breathable spandex overlay
- Weight Capacity: 250 lbs., 300 lbs. (over 20" wide)
Ride Custom 2
- Base: Custom contoured shape polyethylene base (closed cell) redistributes the forces of pressure and shear away from high-risk areas
- Selectively applies forces to more tolerant areas
- Vented and contoured shape assists in keeping skin cool and dry
- Decreases long-term skin risk and aids in sitting stability for improved functional performance
- Seating interface: Off-loading is standard, options of reticulated foam well insert kit and full contact (manufactured as captured)
- Cover: Lightweight breathable polyester spacer mesh fabric with optional breathable spandex overlay, optional additional soft fit options for softer overlay interface
- Weight Capacity: 250 lbs., 300 lbs. (over 20" wide)
Ride Custom AccuSoft Made-From-Measurements
- Made-to-order system fabricated from rider's measurements. Does not require Ride certification to order.
- Base: Customized full contact linear seating surface made of polyurethane foam.
- Seating interface: Immersion / envelopment
- Built-in thigh / femoral support and medial thigh available
- Ability to add in minor pelvic obliquity build up using wedges in posterior cushion
- Cover: Inner wipeable poyester fabric with a polyurethane coating, lightweight breathable polyester spacer mesh fabric with optional breathable spandex overlay
- Weight Capacity: 250 lbs., 300 lbs. (over 20" wide)
JAY Your Way
Choosing and justifying the correct cushion is critical for the health and well-being of a client. JAY Your Way allows for personalized modifications to JAY products, ensuring they meet the specific comfort and positioning needs of clients while maintaining the ease of ordering standard products.
With JAY Your Way, make clinical improvements such as size and base adjustments, fluid insert modifications, and add positioning components. Additionally, you can customize the appearance with colored covers and back shells. These, along with many other modifications, help address unique individual needs and preferences without changing the original cushion code.
References
- Article - Wheelchair Seating - Policy Article (A52505) (cms.gov)