Sunrise Medical Quickie V-121, Quickie V-521, Quickie P-220, Quickie S-525, Quickie P-222 SE Reference Manual

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Page 1

Power Wheelchair Reference Guide

MEDICÅRE–UNLOCK THE MYSTERY

– New Codes

– The LCD - local coverage determination criteria

– ABN - advanced beneficiary notice

Page 2

Rhapsody

Melody CB

eestyle-

F11HD

RhapsodyBB

Trek

STOP 3STOP 2

Freestyle-

M11

Freestyle /tilt

FreestyleM11

GrooveRhythmFreestyleF11

Local Coverage Determination Algorithm

To determine the appropriate group and code a patient will qualify for.

(Chart continued on following page)

The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility related activities of daily living

(MRADLs) such as toileting,

- Prevents the patient from accomplishing an MRADL entirely, Places the patient at reasonably determined heightened risk of morbidity or mor

- Prevents the patient from completing an MRADL

B) The patient’s mobility limitation cannot be sufficiently

C) The patient does not have sufficient

to perform MRADLs during a typical day.

- Limitations of strength, endurance, range of motion, or coordination, presence of pain, or deformity or absence of one or both upper extremities are relevant to the assessment of upper extremity function.

- An optimally-configured manual wheelchair is one with an appropriate wheelbase, device weight, seating options, and other appropriate non-powered accessories.

D) The patient is able to:

- Safely

transfer to and from a POV, and

- Operate the tiller steering system, and

- Maintain postural stability and position while operating the POV in the home.

E) The patient’s mental capabilities (e.g., cognition, judgment) and physical capabilities (e.g., vision) are sufficient

F) The patient’s home provides adequate access between rooms, maneuvering space, and surfaces for the operation of the POV that is provided.

G) The patient’s weight is less than or equal to the weight capacity of the POV that is provided.

H) Use of a POV will significantly

I) The patient has not expressed an unwillingness to use a POV in the home.

THIS STOPS AT A POV OR SCOOTER.

J) The patient has the mental and physical capabilities to safely operate the power wheelchair that is provided; or

K) If the patient is unable to safely operate the power wheelchair, the patient has a caregiver who is unable to adequately propel an optimally

configured manual wheelchair, but is available, willing, and able to safely operate the power wheelchair that is provided; and

L) The patient’s weight is less than or equal to the weight capacity of the power wheelchair that is provided.

M) The patient’s home provides adequate access between rooms, maneuvering space, and surfaces for the operation of the power wheelchair that is provided.

N) Use of a power wheelchair will significantly improve the patient’s ability to participate in MRADLs and the patient will use it in the home.

For patients with severe cognitive and/or physical impairments, participation in MRADLs may require the assistance of a caregiver.

O) The patient has not expressed an unwillingness to use a power wheelchair in the home.

ADDITIONAL CRITERIA GROUP 2 AND ABOVE SLING SEAT

The patient is using a skin protection and/or positioning seat and/or back cushion

THIS STOPS AT A GROUP 1 OR 2– NO POWER OPTION.

ADDITIONAL CRITERIA SINGLE POWER OPTION

1. The patient requires a drive control interface other than a hand or chin operated standard proportional joystick (examples include but are not limited to head control, sip and puff, switch control) OR

2. The patient meets coverage criteria for a power tilt or recline seating system (see Wheelchair Options and Accessories policy for coverage criteria) and the system is being used on the wheelchair AND

3. The patient has had a specialty evaluation that was performed b therapist (OT), or physician who has specific training and experience in rehabilitation wheelchair evaluations and that documents the medical necessity for the wheelchair and its special features. The PT, OT, or physician may have no financial relationship with the supplier.

THIS STOPS AT A GROUP 2 OR 3– SINGLE POWER OPTION.

ADDITIONAL CRITERIA MULTIPLE POWER OPTION

1. The patient meets coverage criteria for a power tilt and/or recline seating system with three or more actuators OR

2. The patient uses a ventilator which is mounted on the wheelchair. AND

3. The patient has had a specialty evaluation that was performed b training and experience in rehabilitation wheelchair evaluations and that documents the medical necessity for the wheelchair and its special features. The PT, OT, or physician may have no financial relationship with the supplier.

ADDITIONAL CRITERIA TO MOVE UP TO A GROUP 3 DEVICE

The patient’s mobility limitation is due to a neurological condition, myopathy or congenital skeletal deformity.

feeding, dressing, grooming, and bathing in customary locations in the home. A mobility limitation is one that:

within a reasonable time frame

upper extremity function to self-propel an optimally-configured manual wheelchair in the home

improve the patient’s ability to participate in MRADLs and the patient will use it in the home.

tality secondar

and safely resolved by the use of an appropriately fitted cane or walker.

that meets the coverage criteria defined in the Wheelchair Seating policy.

y a licensed/certified medical professional, such as a physical therapist (PT) or occupational

y a licensed/certified medical professional, such as a PT or OT, or physician who has specific

y to the attempts to perform an MRADL; or

for safe mobility using a POV in the home.

(Chart continued on following page)

For the most current Local Coverage Determination Algorithm visit our website: www

.sunrisemedical.com

Page 3

GROUP 1 GROUP 2 GROUP 3

V’S

(SCOOTERS)

K0800,K0801,K0802

YES

YES YES YES YES YES YES YES YES YES

YES

STOP

PWC

K0813-K0816

YES YES YES YES YES YES YES YES

NO ON ONE

OF THESE

and

NA NA NA NA NA NA NA NA

ONE OF THESE

IS MET

and

PWC

K0823-K0829

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

Sling/Solid Seat

K0820-K0822

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

Single Power

K0835-K0840

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

Multi Power

K0841-K0843

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

No Power Opt.

K0848-K0855

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

Single Power

K0856-K0860

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

PWC

Multi Power

K0861-K0864

NO ON ONE

OF THESE

and

ONE OF THESE

IS MET

and

YES YES YES YES YES YES YES YES

NO NO YES Not Required Not Required Not Required Not Required Not Required

STOP 1 STOP 2 STOP 3

ONE OF THESE

IS MET

and

YES NA NA YES NA

STOP

NA NA

NA NA NA

ONE OF THESE

IS MET

and

YES NA NA YES

NA NA

ONE OF THESE

IS MET

and

ONE OF THESE

IS MET

and

STOP

YES YES YES

STOP STOP STOP

Page 4

Scooter Mid Mid Rear Rear Mid Rear Mid Mid Mid Mid Mid Mid Rear Rear Mid Mid Mid Mid Front/Rear Mid Front/Rear Mid Mid Front/Rear Mid Front/Rear Mid Mid Front/Rear Rear Rear Mid Rear Mid Rear Mid Rear Rear

4.0 mph 4.0 mph 4.0 mph 4.5 mph 4.5 mph 4.0 mph 4.0 mph 4.0 mph 4.0 mph 4.0 mph 4.0 mph 4.0 mph 4.0 mph 6.5 mph 4.5 / 6.5 mph 4.0 mph 6.0 mph 5.5 mph 6.5 mph 5.0 mph / 6.5 mph 5.0 mph 5.0 mph 6.0 mph 6.5 mph 5.0 mph / 6.5 mph 5.0 mph 5.0 mph 6.0 mph 6.5 mph 5.0 mph 7.0 mph 6.0 mph 8.5 mph 8.5 mph 8.5 mph 7.0 mph 8.5 mph 6.0 mph 8.5 mph

250 lbs 300 lbs 300 lbs 250 lbs 300 lbs 300 lbs 250 lbs 300 lbs 300 lbs 400 lbs 400 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 165 lbs 300 lbs 300 lbs 400 lbs 400 lbs 300 lbs 300 lbs 300 lbs 400 lbs 400 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs 300 lbs

P&G P&G P&G P&G P&G P&G P&G P&G P&G P&G P&G P&G** P&G** P&G** P&G** P&G* P&G**

N/A

Dynamic

Suspension

Overland N/A N/A Overland N/A Dynamic SFS

Dynamic

Suspension

Overland Overland Overland

T3: 32" T4: 44.5" 20" 20.5" 33.5" 33.5" 20.5" 24.5" 21" 20" 22.5" 22.5" 20.5" 20" 25" 32" 20.5" 22.5" 20.5" 21" 28" 21" 28" 22.5" 21" 28" 21" 28" 22.5" 21" 28" 25" 34" 21" 28" 21" 25" 21" 34" 28"

Stadium Rehab Rehab Rehab Rehab Captains

Captain's

Lo Back

Captain's

Lo Back/High Back

Captains Rehab Captains Rehab Rehab Rehab Rehab Perfect Fit Rehab Rehab

16" 16", 18"

16", 18", 20"

14-20 14-20 18", 20", 22" 18" 18" 16", 18", 20"

18-20"*, 22", 24"

*1" increments

22" 16", 18", 20" 16" & 18" 14" - 24" 14" - 20"

N/A 16", 18" 16", 18", 20" 14-18 14-18 16", 18", 20" 17"

LoBack: 17"

HighBack: 17"-19"

16" - 20" 18", 19", 20" 20" 16", 18", 20" 16" & 18" 14" - 26" 14" - 20"

N/A 15° 30° 30° 30° 30° 7°

LoBack: 7°

HighBack: upto 30°

up to 40° 30° 30° 30° 15° 30° 30° 30° 30° 25° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30° 30°

16.5"-20.5" 16.5"-20.5" 15.5"-19.5" 18.5" 18.5" 17" - 21" 21"-22" 18" & 19.5" 17" - 21" 17.5" - 21.5" 19" - 23" 15.5"-19.5" 16.5"-20.5" 18" 18" 17.5"-21.5" 17.5" 15.5"-19.5" 16.8"-20.1" 17.3"-20.6" 16.8"-20.1" 17.3"-20.6" 19"-23" 16.8"-20.1" 17.3"-20.6" 16.8"-20.1" 17.3"-20.6" 17.5" - 21.5" 17.1"-20.1" 17.6"-20.6" 18" 18"-21" 16.8"-20.1" 17.3"-20.6" 16.8"-20.1" 18"-20" 17.1"-20.1" 18"-21" 17.6"-20.6"

No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options Choose One Choose One Choose One Choose One

-- -- -- -- -- -- -- -- -- -- -- • • • • • -- -- -- -- -- -- • • • • • • • • -- -- -- -- • • • • •

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- • -- -- -- -- -- -- -- • • -- -- • • • -- -- -- -- • -- • • •

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- • • -- -- -- • • -- -- -- -- • -- • -- •

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- • -- -- -- -- -- -- -- -- -- -- -- • • • -- -- -- -- -- -- • • •

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- • • -- -- • • • -- -- -- -- • -- • • •

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A • • • • N/A • • • • N/A • • N/A • • • • N/A • • •

12V, 12Ah, x 2 U1 or 50Ahr U1 or 50Ahr U1, Group 22NF U1, Group 22NF U1 or 50 Ahr 2 - 12 amp/hr U1 U1 or 50Ahr

Group 22NF or

Group 24

Group 24 U1 or 50Ahr U1 or 50Ahr

7.5" 10" 10" 12" 12" 10" 8" 10" 10" 14" 14" 10" 10" 12" 12" 10" 14" 10" 14" 14" 14" 14" 14" 14" 14" 14" 14" 14" 14" 14" 12" 14" 14" 14" 14" 12" 14" 14" 14"

20" 23.5" 22.5" 19.5" - 25.5" 19.5" - 25.5" 22.5" 22.5" 23.5" 23.5" 24.5" 24.5" 22.5" 23.5" 24.5" 22.25" - 26.25" 22.5" 24.5" 22.5" 25.5" 25.5" 25.5" 25.5" 24.5" 25.5" 25.5" 25.5" 25.5" 24.5" 25.5" 25.5" 24.5" 25.75" 25.5" 25.5" 25.5" 24.5" 25.5" 25.75" 25.5"

38" 38" w/ footplate

38.5" w/footplate

32" w/out footplate

31" - 33"

w/o hangers

30" - 34"

w/o hangers

38.5" w/footplate

32" w/out footplate

32"

36.5" w/footplate

33" w/out footplate

38" w/footplate

39" w/footplate

33" w/out footplate

39" w/footplate

33" w/out footplate

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Yes Yes N/A N/A Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes N/A Yes Yes No No Yes Yes Yes No Yes No Yes

BRONZE SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER SILVER GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD GOLD PLATINUM PLATINUM PLATINUM PLATINUM PLATINUM PLATINUM PLATINUM PLATINUM PLATINUM

GROUP 1 GROUP 2 - (Continued on next page)

BEST PICK BEST PICK BEST PICK

K-Code

Allowable

Product

Model

Drive Wheel

Position

Max. Speed

User Weight

Capacity

Electronics

Suspension

Turning Radius

Seat Selection

K0800

$1292.77

Trek 3 Trek 4

Quickie

Rhapsody

Rehab Seat,

Quickie

Freestyle

K0822

$4008.10

Std Weight Cap.

Quickie

V-121

Quickie

V-521

Quickie

Freestyle

$4023.70

Captains Seat,

Quickie Melody

K0823

Std. Weight Cap.

Quickie Prelude

Rhapsody

Trek 3/4 BB M11 BB V-121 V-521 M11 CB Melody CB CB CB

Quickie

Width

Depth

Back Angle

Seat-to-Floor

Height

Powered Seating

Tilt

Recline

Lift

ELR

Power Center Mt. ALR

ent T

Batteries

Wheels

Drive

Overall

Base Width

Overall Length

ested

ransit T

Warranty

Key of Quickie Suffixes 1st Letter 2nd Letter B= Basic Rehab Seat A= Group 1 C= Captain’s Seat B= Group 2

Medicare Best Picks

Warranty: For detailed warranty information visit our website:

.sunrisemedical.com

www

S= Single Power Option C= Group 3 MP= Multiple Power Option D= Group 4

Examples: CB=Captain’s Seat, Group 2

SC=Single Power Option, Group 3

Page 5

Dynamic

Suspension

Rear Stabilizers N/A Overland Overland Overland 6-Form Suspension 2-Form Suspension 6-Form Suspension 2-Form Suspension Overland 6-Form Suspension 2-Form Suspension 6-Form Suspension 2-Form Suspension Overland 6-Form Suspension 2-Form Suspension Rear Stabilizers Fox-Shocks 6-Form Suspension 2-Form Suspension 6-Form Suspension Rear Stabilizers 6-Form Suspension Fox-Shocks 2-Form Suspension

18-20"*, 22", 24"

*1" increments

22" 16", 18", 20" 16" & 18" 14" - 24" 14" - 20"

12" - 20"

in 1" increments

16", 18", 20" 14" - 24" 14" - 24" 14" - 24" 15" - 24" 16", 18", 20" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24"

12" - 18"

in 1" increments

16", 18", 20" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 16", 18", 20" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 14" - 24" 14" - 22" 12" - 24" 12" - 24" 12" - 24" 14" - 24" 12" - 24" 14" - 22" 12" - 24"

Select two or more

options

No Power Options No Power Options No Power Options No Power Options No Power Options No Power Options Choose One Choose One Choose One Choose One Choose One No Power Options No Power Options No Power Options No Power Options Choose One Choose One

Group 22NF or

Group 24

Group 24 U1 or 50Ahr U1 or 50Ahr

Group 22NF or

Group 24

Group 22NF U1 or 50Ahr U1 or 50Ahr Group 24

39" w/footplate

33" w/out footplate

39" w/footplate

33" w/out footplate

38.5" w/footplate

32" w/out footplate

38" w/footplate

31.5"

w/o footplates

27" w/o footrest

or ant-tips

38.5" w/footplate

32" w/out footplate

39" 39" 39" 39" 39" 39" 39" 39" 39" 39" 29.5" 39" 39" 39" 39" 29.5" 39"

GROUP 2 - Continued

BEST PICK BEST PICK BEST PICK BEST PICK BEST PICK

K-Code

Allowable

Product

Model

Drive Wheel

Position

Max. Speed

User Weight

Capacity

Electronics

Suspension

Turning Radius

Seat Selection

K0824

$4842.70

Rehab Seat,

Quickie

Freestyle

K0825

$4229.60

Captains Seat,

Quickie

Freestyle

Quickie

Freestyle

Rehab Seat,

Quickie

Rhapsody

K0835

$4132.30

Single Power Option

Quickie

P-220

Quickie

S-525

K0841

$4318.60

Multi Power

Option

Quickie

Freestyle

Coming Soon!

F11 BB HD F11 CB HD M11 SB SB P-220 S-525 M11 MPB

Width

Depth

Back Angle

Seat-to-Floor

Height

Powered Seating

Tilt

Recline

Lift

ELR

Power Center Mt. ALR

ent T

Batteries

Wheels

Drive

Overall

Width

Base

Overall Length

ested

ransit T

arranty

Page 6

Quickie

Electronics**

Quickie

Electronics**

Quickie

Electronics**

Quickie

Electronics

Quickie

Electronics

P&G**

Quickie

Electronics**

Quickie

Electronics**

Rehab &

Perfect Fit

Rehab &

Perfect Fit

Rehab &

Perfect Fit

Rehab &

Perfect Fit

Rehab

Rehab &

Perfect Fit

Rehab &

Perfect Fit

10" - 18"

in 1" increments

14" - 24" 14" - 24" 14" - 24" 15" - 24" 16", 18", 20" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24"

13" - 20"

in 1" increments

12" - 24" 12" - 24" 12" - 24" 12" - 24" 16", 18", 20" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 12" - 24" 14" - 24" 14" - 22" 12" - 24" 12" - 24" 12" - 24" 14" - 24" 12" - 24" 14" - 22" 12" - 24"

Group 22NF or

Group 24

U1 or 50Ahr

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or Group 22 NF

Group 24 or

Group 22 NF

39" w/footplate

33" w/out footplate

38.5" w/footplate

32" w/out footplate

39" 39" 39" 39"

39" w/footplate

33" w/out footplate

39" 39" 39" 39" 39" 39" 29.5" 39" 39" 39" 39" 29.5" 39"

GROUP 3 - (Continued on next page)

BEST PICK BEST PICK BEST PICK BEST PICK BEST PICK BEST PICK

K-Code

Allowable

Product

Model

Drive Wheel

Position

Max. Speed

User Weight

Capacity

Electronics

Suspension

Turning Radius

Seat Selection

Quickie

Freestyle

$5433.60

Rehab Seat,

Zippie Z-Bop

K0848

Std. Weight Cap.

Quickie Rhythm

Quickie

Groove

Quickie Rhythm

K0850

$6139.90

Rehab Seat,

Quickie

Groove

Quickie

Freestyle

$5672.30

Single P

K0856

ower Option

Quickie Rhythm

Quickie Groove

F11 BC Z-Bop BC BC BC HD BC HD F11 SC SC SC

Width

Depth

Back Angle

Seat-to-Floor

Height

Powered Seating

Tilt

Recline

Lift

ELR

Power Center Mt. ALR

ent T

Batteries

Wheels

Drive

Overall

Width

Base

Overall Length

ested

ransit T

arranty

Page 7

Quickie

Electronics**

Quickie

Electronics**

P&G*

Quickie

Electronics*

Quickie

Electronics*

P&G** P&G**

Quickie

Electronics**

Quickie

Electronics**

P&G** P&G*

Rehab &

Perfect Fit

Rehab &

Perfect Fit

Perfect Fit Perfect Fit Perfect Fit Rehab Rehab

Rehab &

Perfect Fit

Rehab Rehab Rehab Rehab Rehab Rehab

12" - 20"

in 1" increments

14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24" 14" - 24"

12" - 18"

in 1" increments

12" - 24" 12" - 24" 14" - 24" 14" - 22" 12" - 24" 12" - 24" 12" - 24" 14" - 24" 12" - 24" 14" - 22" 12" - 24"

Select two or more

options

More than one

option

More than one

option

No Power Options No Power Options No Power Options No Power Options Choose One Choose One

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

39" w/footplate

33" w/out footplate

39" 39"

31.5"

w/o footplates

29.5" 39" 39" 39" 39" 29.5" 39"

GROUP 3 - Continued GROUP 4 - (Continued on next page)

BEST PICK BEST PICK BEST PICK

K-Code

Allowable

Product

Model

Drive Wheel

Position

Max. Speed

User Weight

Capacity

Electronics

Suspension

Turning Radius

Seat Selection

$7037.60

HD Single P

Quickie Rhythm

K0858

ower Option

Quickie

Groove

Quickie

Freestyle

$5681.40

Multi P

K0861

ower Option

Quickie Rhythm

Quickie Groove

Quickie

P-222 SE

SC HD SC HD F11 MPC MPC MPC P-222 SE BD

K0868***

Activity, No Power Option

High

Quickie

S-646 / S-646 SE

S-646/S-646 SE BD

Quickie Rhythm

BD BD

Quickie Groove

Width

Depth

Back Angle

Seat-to-Floor

Height

Powered Seating

Tilt

Recline

Lift

ELR

Power Center Mt. ALR

ent T

Batteries

Wheels

Drive

Overall

Width

Base

Overall Length

ested

ransit T

arranty

Page 8

K-Code

Quickie

Electronics**

P&G**

Quickie

Electronics*

P&G*

Quickie

Electronics*

More than one

option

More than one

option

More than one

option

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or

Group 22 NF

Group 24 or Group 22 NF

Group 24 or

Group 22 NF

31.5"

w/o footplates

39" 29.5" 39"

Allowable

GROUP 4 - Continued

BEST PICK BEST PICK

K0877***

Activity, Single Power Option

High

K0884***

Activity, Multi Power Option

High

GROUP 1

Standard PWC Captains Chair and weight capacity up to and including 300 lbs

• K0800 Portable PWC

• K0816 non-portable PWC

Product

Model

Drive Wheel

Position

Max. Speed

User Weight

Capacity

Electronics

Suspension

Turning Radius

Seat Selection

Width

Depth

Back Angle

Seat-to-Floor

Height

Powered Seating

Tilt

Recline

Lift

ELR

Power Center Mt. ALR

ent T

Batteries

Quickie Rhythm

Quickie

P-222 SE

Quickie

Rhythm

Quickie

S-646 / S-646 SE

Quickie Groove

GROUP 2

Standard PWC with weight capacity up to and

SD P-222 SE SD MPD

S-646/S-646 SE MPD

MPD

including 300 lbs

• K0822 Rehab Seat

• K0823 Captains Seat

• K0824 Rehab Seat, HD

•

K0825 Captains Seat, HD

• K0835 Rehab Seat, Single Power Option

• K0841 Multiple Power Option

GROUP 3

Standard PWC with weight capacity up to and including 300 lbs

• K0848 Rehab Seat

• K0850 Rehab Seat, HD

• K0856 Single Power Option

• K0858 Single Power Option, HD

• K0861 Multiple Power Option

Drive

Base

Overall Length

ransit T

Wheels

Overall

Width

arranty

ested

*Ships standard with expandable electronics.

* *Expandable electronics available as an option.

** *No allowable assigned.

GROUP 4

High Activity

•

• K0877 Single Power Option

•

K0868 No Power Option

er Option

K0884 Multiple P

Page 9

Driving Controls and Electronic Components

Can the consumer manage a standard proportional joystick?

Does consumer need to operate 1 power actuator (tilt or recline) thru the joystick?

Does consumer sometimes require driving assistance in small spaces (van entry/bed transfers) or management of power seat functions in time of medical

Non Expandable

Electronics

emergency (hypotension, autonomic dysreflexia)?

Does consumer need to operate 2 actuators (tilt and recline) thru the joystick?

Is consumer able to manage standard joystick but requires multiple drive profiles with individualized programming for safe driving in customarily encountered environments such as van entry, home environments, community mobility?

Joystick (no additional billable code)

• Needs 0 or 1 power seat function

• Seat function (tilt) doesn’t have to be operated using joystick

• No need for upgrade to specialty controls

E2310

• Thru drive power seat function

•

E2310 – Operation of one seat function thru input device

Attendant control

E2331

– Attendant control

E2311

• Thru drive power seat functions

•

E2311 – Operation of > 2 seat functions thru input device E2377 – Expandable electronics

•

E2377

• Joystick control

E2377 – Expandable electronics

•

Is consumer unable to manage standard joystick but can manage a mini, compact or short throw joystick or other specialty control device?

Mechanical Switches

E2377

– Expandable electronics

E2322 – Mechanical switches E2310– E2311 – Thru input device control of > 2 power seat functions

Thru input device control of 1 power seat function or

Non Proportional Head Array

E2377 – Expandable electronics E2329 – Non proportional head array E2310 – Thru input device control of 1 power seat function or E2311 – Thru input device control of > 2 power seat functions

Does consumer sometimes require driving assistance in small spaces (van entry/bed transfers) or management of

Expandable Electronics

power seat functions in time of medical emergency (hypotension, autonomic dysrefle

xia)?

Mini/compact joystick

E2377

– Expandable electronics

E2373 – Mini proportional joystick E2310 / E2311 – Thru input device control of

> 2 power seat functions

1 or

Sip and Puff Interface

Expandable electronics

–

E2377 E2325 – Sip and puff interface E2326 – Breath tube kit E2310 – Thru input device control of 1 power seat function or E2311 – Thru input device control of > 2 power seat functions

roportional Head Array

E2377

– Expandable electronics

E2328 – Proportional head array E2310 – Thru input device control of 1 power seat function or E2311 – Thru input device control of > 2 power seat functions

Attendant control

E2377 – Expandable electronics E2331 – Attendant control

102277 Rev. D

Sunrise Medical Quickie V-121, Quickie V-521, Quickie P-220, Quickie S-525, Quickie P-222 SE Reference Manual

Specifications and Main Features

Frequently Asked Questions

User Manual