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 Stingray Pediatric Stroller

In order to get this approved we need a prescription stating, “SingRay Pediatric Tilt n Space Wheelchair.”

 

In addition to a detailed letter of medical necessity, stating why this wheelchair is needed and why a standard wheelchair is not safe for him it should include ALL the diagnosis the child has . . .

 

A patient can qualify for this stroller up to 88lbs. Anything above that will have to get the typical looking custom wheelchair. (keep in mind – the chair has to last up to 5 years. So if the patient is 80lbs, I would not recommend it, but rather a choice of some very nice custom wheelchairs.)

 

DX:

Cerebral Palsy

Autism,

Seizure disorder

Mental retardation

(or other Dx’s that prevent a child from normal ambulation in addition to poor trunk support where additional accessories and options are needed to safely position the child.)

 

Wheelchair Base

  • E1233 - EASyS Size 1 - StingRay folding frame Custom Wheelchair – An ultra lightweight multi-adjustable Tilt N Space wheelchair. – To assist with seating a positioning in addition to all ADL’s

  • K0108 - Transit Option – Enables security while traveling on a bus or other methods of transportation.

  • Standard angle adjustable push handles – enables parent or guardian to safely push the wheelchair.

  • Elevating in/out front mount hangers – to assist safe transfers

  • K0040 - Adult angle adjustable footplates with heel loops – to protect the foot from hitting the chair or obstacle in the way of the chair.

  • High mount push to lock brakes – to securely lock the wheelchair in place when at rest and or to transfer.

 

Seating System

  • E2291 - EASyS Size 1 integrated seat-back planar  – to position properly while sitting

  • E2292 - EASyS Size 1 integrated seat planar– to position properly while sitting

 

  • E1014 - Size 1 Recline function – To assist in seating and positioning

  • E0956 - Lateral and hip /supports guides and  E0957 -Pummel– to position while sitting and help prevent abduction.

  • E0955 - Headrest – to position the head well while sitting and to keep the head secure while in transit.

  • E0960 - Harness- for better trunk support

  • E0978 - Seatbelt- for better pelvic positioning as well as support in the chair

  • E0950 – Upper extremity support/ tray – to position and support the upper extremities.

  • K0108- Canopy – To protect from sunlight and other poor weather conditions that may be harmful.

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