Gunnell - Seating & Positioning HCPCS Order Form

Seating & Positioning HCPCS
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Choose Your Products to Begin Customization*

Occipital Cradles With HardwareOccipital Cradles Without HardwareOccipital Cradle Mounting HardwareSeating PackagesSeating HardwareTraysTray HardwareGel CushionsHip PadsHip Pad HardwareAbductorsAbductor HardwareReplacements PartsPositioning AccessoriesChest StrapsH-HarnessBack Rest PackagesBack Rest Hardware

Occipital Cradles Without Hardware
Occipital Cradles Without Hardware
Occipital Cradles Without Hardware*
Codes: E0955
Occipital Cradles Without Hardware Total

Occipital Cradle Mounting Hardware
Select Headrest Mounting Hardware*
Code: E1028
Hardware Only Total

Seating Packages
Seating Packages
Choose Your Package to Begin Customization*

Solid Seat*
Code/s: E2607 or E2608 and/or K0108

Anti-Thrust Seat*
Code/s: E2607 or E2608 and/or K0108

Wedge Seat*
Code/s: E2607 or E2608 and/or K0108

I-Modification Seat*
Code/s: E2607 or E2608 and/or K0108

Contoured Seat*
Code/s: E2607 or E2608 and/or K0108
Seat Total
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.
Seating Configuration Chart

A (center) = Attachment holes for an Abducter Bracket B = Attachment holes for Hip Pad Brackets and/or Lateral Support Brackets

	Dimensions
A
B

	Dimensions
A
B
C
D

	Dimensions
A
B
C
D

	Dimensions
A
B
C
D
E

	Dimensions
A
B
C
D
E
F
G
H
I

Seating Hardware
Seating Hardware
Choose Your Seating Hardware K0108*

QRSH Quick Release Seating Hardware $222.75SAH Standard Seating Hardware $189399 Custom Seating Hardware Quote Only
Seating Hardware Total
Custom Hardware is available upon request. Please Ask!

Trays
Trays
531 Polycarbonate Tray with Black PVC Rim w/Straps*
Code/s: E0950 and/or K0108
Tray Total
Add Ons

⁫ 532 Polycarbonate Tray Trough Style Hardware $675⁫ 533 Polycarbonate Tray EZ Lock Clamp Hardware $810⁫ 534T Polycarbonate Tray with Padding $1,059.75
⁫ 532 Polycarbonate Tray Trough Style Hardware $675 Total
533 Polycarbonate Tray EZ Lock Clamp Hardware $810 Total
534T Polycarbonate Tray with Padding $1,059.75 Total

Tray Hardware
Tray Hardware
Hardware*

⁫ 532 Polycarbonate Tray Trough Style Hardware $675⁫ 533 Polycarbonate Tray EZ Lock Clamp Hardware $810⁫ 534T Polycarbonate Tray with Padding $1,059.75
⁫ 532 Polycarbonate Tray Trough Style Hardware Only $675 Total
533 Polycarbonate Tray EZ Lock Clamp Hardware Only $810 Total
534T Polycarbonate Tray with Padding $1,059.75 Total

Gel Cushions
Gel Cushions
High Density Leak Proof Gel Packs with Sunmate Foam Incasement *
Code: E2609

Hip Pads
Hip Pads
Hip Pad Options*
Code: E0956

Hip Pad Dimensions*

	Dimensions
H
L

656XN Hip Pads without Hardware $202.50/pair Total
⁫656X Hip Pads with Hardware $151.20/pair
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.

Hip Pad Hardware
Hip Pad Hardware*
Code: E0956
⁫656X Hip Pads with Hardware Only $151.20/pair

Abductors
Abductors

(All Abduction Systems Use ¼-20 Bolts & Nuts)
Choose Your Package*
Code/s: E0957 and E1028
Flip Down Abduction System with Adjustable Pummel Dimensions*
Code/s: E0957 and E1028

Flip Down Abduction System with Depth Adjustment*
Code/s: E0957 and E1028
Regular Abduction System with Depth Adjustment*
Code/s: E0957 and E1028
Laterally Adjustable Regular Abduction System with Depth Adjustment*
Code/s: E0957 and E1028
Regular Scissor Board Abduction System with Depth Adjustment*
Code/s: E0957 and E1028
Regular Adduction System with Depth Adjustment*
Code/s: E0957 and E1028
Laterally Adjustable Regular Adduction System with Depth Adjustment*
Code/s: E0957 and E1028
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.
Abductor Total

Abductor Hardware
Regular Scissor Board Abduction System with Depth Adjustment*
Code/s: E0957 and E1028
Abductor Hardware Total

Abductor Replacement Parts
Choose Abductor Replacement Parts*

S067 Abductor/Adductor Fleece Cover $50.42S072 Scissor Board Fleece Cover $50.42S068 Abductor/Adductor Dartex Cover $102.40S070 Scissor Board Dartex Cover $102.40SPU102 Med. Abductor Pad $104.36
S067 Abductor/Adductor Fleece Cover Quantity*
S072 Scissor Board Fleece Cover Quantity*
S068 Abductor/Adductor Dartex Cover Quantity*
S070 Scissor Board Dartex Cover Quantity*
SPU102 Med. Abductor Pad Quantity*
S067 Abductor/Adductor Fleece Cover $50.42 Total
S072 Scissor Board Fleece Cover $50.42 Total
S068 Abductor/Adductor Dartex Cover $102.40 Total
S070 Scissor Board Dartex Cover $102.40 Total
SPU102 Med. Abductor Pad $104.36 Total

Chest Straps
Chest Straps

D-Ring used with Chest Strap Ring Styleand 1/2” Pad and each can be made tocustom lengths.
Chest Straps
Chest Strap Total

H-Harness
H-Harness
H-Harness
S035
H-Harness Total
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.

Back Rest Packages
Back Rest Packages

(All Packages Shown with Quick Release Hardware)
Choose Your Package to Begin Customization*
Solid Back*
Code/s: E2613 or 2614 and/or K0108

Bi-Angular Back*
Code/s: E2613 or 2614 and/or K0108

Curved Back*
Code/s: E2613 or 2614 and/or K0108

I-Modification Back*
Code/s: E2613 or 2614 and/or K0108

Back Rest Total
Planar Back Configuration Chart

B = Attachment holes for Torso/Lateral Pad Brackets 10-32 T-NutsC = Attachment holes for an Occipital Head Cradle Bracket
Planar Hardware
Choose Planar Hardware*
Code: K0108
Planar Hardware Total
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.

	Dimensions
A
B

	Dimensions
A
B
C
D

	Dimensions
A
B
C
D

	Dimensions
A
B
C
D
E
F

Back Rest Hardware
Planar Hardware
Choose Planar Hardware Code: K0108

QRBH Quick Release Back Hardware $330.75BAH Standard Back Hardware $220.59399 Custom Seating Hardware Quote Only
Custom Hardware is available upon request. Please Ask!
Planar Hardware Only Total
NOTE: HCPCS Codes provided were determined by SADMERC and/or interpretations of the codes. Proper use of codes does not ensure coverage or payment. Please contact a Medicare professional for further assistance.

Footnotes
Footnotes
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Email: support@gunnell-inc.com • Tel: 800-551-0055 • Fax: 800-794-5483

Specifications and prices are subject to change without notice.
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Seating & Positioning HCPCS

Occipital Cradles With Hardware

Occipital Cradles Without Hardware

Seating Packages

Seating Configuration Chart

Seating Hardware

Trays

Tray Hardware

Gel Cushions

Hip Pads

Abductors

Hip Belts

Chest Straps

H-Harness

Back Rest Packages

Planar Back Configuration Chart

Planar Hardware

Planar Hardware

Footnotes