Java Decaf Back for wheelchairs

Widths
10” (25cm), 12” (30cm), 13” (33cm), 14” (36cm)

Heights
Regular: 10” (25cm), 12” (30cm)
Tall: 13” (33cm), 15” (38cm)

Weight*
Including hardware: 3.0 – 3.5 lbs (1.4 – 1.6kg); Carrying Weight: 2.2 – 2.7 lbs (1.0 – 1.2kg)
*Depends on width, depth, and height chosen

Weight Capacity
200 lbs (91kg)

Angle/Recline
Infinite

Seat Depth Range of Adjustment
Up to 8.5” (22cm), depending on wheelchair width

Construction
(Materials Used)
Insert material: ½” (1.3cm) polyurethane foam over ¼” (0.6cm) polyethylene closed cell foam;
Shell material: aluminum

Outer Cover Construction
(Outer surface that contacts skin)
Breathable polyester spacer fabric laminated to vapor permeable urethane

Java® Decaf Back & Java® Decaf Back Tall

Medicare Code
E2615: Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware

2017 Medicare Fee Schedule*
Non-Rural Fee

E2615 NU: Varies by state, please see attached spreadsheet
E2615 NU KU: $434.00
E2615 RR: Varies by state, please see attached spreadsheet
E2615 RR KU: $43.41

Rural Fee
E2615 NU: $368.66
E2615 NU KU: Medicare did not publish a set allowable
E2615 RR: $36.87
E2615 RR KU: Medicare did not publish a set allowable


 

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).

Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Pricing Category
Inexpensive & Routinely Purchased
Download information sheet at right for complete funding information

Optional Quick Release Hardware:
Under Medicare guidelines, there is not a specific HCPCS code for quick release hardware to be used on a wheelchair back. As the Wheelchair Back Code specifics, any type mounting hardware is included. If the hardware is billed as a replacement part, code K0108 would have to be used; code E1028 is not allowed to be used for seat or back hardware.

Please Note

Ride Designs does not sell directly to the public, rather through Ride® certified providers. Please call the Ride Customer Service team at 866-781-1633 for assistance in finding your closest Ride supplier.

Questions?

Check out our FAQ section, send us an email, or give us a call at 866-781-1633.

Standard Accessories

  • Outer Cover (1)
  • Adjustable Mount (1)
  • Pelvic Wedges (pair)
  • Flexa-just® Stays (pair)
  • FlexLoc® Mounting Hardware
  • Owner's Handbook (1)

Additional Accessories

  • Fixed Lateral Trunk Supports, Flat and Curved (pair)
  • Swing-Away Lateral Trunk Supports, Flat and Curved (pair)
  • Additional Flexa-just Stays (pair)
  • Universal Headrest Mounting Plate
  • Extra Outer Cover
  • Additional Pelvic Wedges (pair)
  • Quickie® Fold-Down Push Handle Adaptor
  • Ride Privacy Flap
  • Growth Kit
Interested in becoming a Certified Ride Provider?
Click a link at the right to download an application.