MEDICARE "E" CODES
SUGGESTIONS FOR CODING OF Stealth PRODUCTS
Head Support
Products covered in this section:
- SU500 Fixed Mount - SU510 FM - SU600FM-SU610FM
Suggested List Price = $235 - CP100Fixed Mount - CP200FM - SLP = $242
- CB300Fixed Mount - CB310FM - SLP = $375
- STLOTLGFM - SLP = $175
- STLOTSMFM - SLP = $160
IMPORTANT NOTESThe above headrests (Fixed Mount with Pad) are covered under code E0955
• E0955 pertains to the pad and is reimbursed at *$202.18
- SU500-SU510-SU600-SU610 - SLP = $285
- CP175-CP275 - SLP = $292
- CP150/CP250 Pad - SLP = $142 - E0955
- HMO475 Removable Attaching Hardware - SLP = $150 - E1028
- CB300-CB310 - SLP = $425
- 300 Combo Adjustable Pad - SLP = $275- E0955
- HMO475 Removable Attaching Hardware - SLP = $150 - E1028
- STLOTLG-175 - SLP = $225
- STLOTSM-175 - SLP = $210
- TWB480 (LINK Hardware - Option for above systems) - SLP = $220
IMPORTANT NOTESThe above headrests are covered under codes E0955 and E1028
• E0955 pertains to the pad and is reimbursed at *$202.18
• E1028 pertains to the removable hardware and is reimbursed at *$206.54
Lateral Swing Away System
Products covered in this section:
- SUS9-R / SUS9-L - SLP = $180 each (Swing Away Hardware without pad)
- CPS9-R / CPS9-L / OTTOSP-R / OTTOS-L / QRS9-R / QRS9-L (R= RIGHT. L= LEFT) - SLP = $180 each (Swing Away Hardware without pad)
- P/N900 / 910 / 920 » PADS for above components - SLP = $50 each
Head/Neck Positioning System (Stealth Ultra)
Products covered in this section:
- The ULTRA SYSTEM/Sub Occipital, SU100, SU110, SU300, SU310
- ARMS260-I - SLP = $250
System Components
- HMS-450 Removable Attaching Hardware - SLP = $195 - E1028
- Occipital Pad - SLP = $60 - EO955 (With Fixed Mount HArdware)
- Sub Occipital - SLP = $60 - K0108
- SU950 Adjustable Channel Assembly - SLP = $195 K0108
IMPORTANT NOTESThe above products are covered under codes E1028, E0955 and K0108.• Removable Hardware (HMS450) covered under E1028. Reimbursed at *$206.54• Occipital Pad covered under E0955 with Fixed Hardware at *$202.18
Lateral Support
Products covered in this section:
- TWB-L (Left and Right if applicable) - SLP = $225 each
Swing Away Joystick/Display Mounts
Products covered in this section:
- ARMS260-Q - SLP = $250
- ARMS260-I - SLP = $250
Flip Down & Removable Hardware
Products covered in this section:
- FDM350 - SLP = $150
Sip & Puff Devices
Products covered in this section:
- SP625 - SLP = $275