Invacare Tracer IV Wheelchair Order and Configuration Guide

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Special Note

HCPCS codes are not intended to be, nor should they be considered billing or legal advice. Providers are responsible for determining the appropriate billing codes when submitting claims to the Medicare Program and should consult an attorney or other advisor to discuss specific situations in further detail.

Pre-Configured Stock Wheelchairs

Stock Chairs

Composite handrim standard on stock models.

T420RDAP 20" x 18" Heavy Duty Frame with Fixed Height Conventional Desk Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2201
T420RFAP 20" x 18" Heavy Duty Frame with Fixed Height Conventional Full Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2201
T422RDAP 22" x 18" Heavy Duty Frame with Fixed Height Conventional Desk Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2201
T422RFAP 22" x 18" Heavy Duty Frame with Fixed Height Conventional Full Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2201
T424RDAP 24" x 18" Heavy Duty Frame with Fixed Height Conventional Desk Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2202
T424RFAP 24" x 18" Heavy Duty Frame with Fixed Height Conventional Full Arm, 8" Caster and 24" Rear Wheels - $1,239.37 K0007 + E2202
T4X22RDAP 22" x 18" Heavy Duty Frame with Fixed Height Conventional Desk Arm, 8" Caster and 24" Rear Wheels - $1,556.25 K0007+E2201
T4X24RDAP 24" x 18" Heavy Duty Frame with Fixed Height Conventional Desk Arm, 8" Caster and 24" Rear Wheels - $1,556.25 K0007 + E2202

Stock Front Riggings

T93HCP Hemi Sw. Footrests Composite Footplates w/ Heel Loops - $99.13 E0951
T93HAP Hemi Sw. Footrests Aluminum Footplates w/ Heel Loops - $99.13 E0951
T94HCP Hemi Sw. Elev Legrests Composite Footplates & Padded Calf Pad - $191.86 K0195
T94HAP Hemi Sw. Elev Legrests Aluminum Footplates & Padded Calf Pad - $191.86 K0195

Stock Options

☐ 1514 Overhead Anti-Theft Device - $49.27 (Only available on 18" and 20" widths.)
☐ 1497 Oxygen Holder Package Assembly - $161.72 E2208
☐ 1496 IV / Oxygen Holder Package Assembly - $169.22 K0105+E2208
☐ 1360 Adjustable Rear Anti-Tipper For 8" Casters - $87.82 E0971

Frame and Seat Selections

Chair Type

☐ T4 Tracer IV Wheelchair - 1,568.00 K0007

Frame Width

☐ WD88 18" Wide x 18" Deep - No Charge
☐ WD80 18" Wide x 20" Deep - No Charge E2203
☐ WD08 20" Wide x 18" Deep - No Charge E2201
☐ WD202 20" Wide x 20" Deep - No Charge E2201 + E2203
☐ WD28 22" Wide x 18" Deep - No Charge E2201
☐ WD2220 22" Wide x 20" Deep - No Charge E2201 + E2203
☐ WD2418 24" Wide x 18" Deep - No Charge E2202
☐ WD2420 24" Wide x 20" Deep - No Charge E2202 + E2203

Seat-to-Floor Height

☐ A Adult (19.5" STF) Standard
☐ H Hemi (17.5" STF) - No Charge

Weight Capacity

☐ 350 350 lbs. maximum weight capacity - No Charge
☐ 450 450 lbs. maximum weight capacity - No Charge (To achieve a 450 lbs. weight capacity, upgraded casters (1228) and wheels (5244BK) will be required and will be automatically selected.)

Arm and Back Options

Arm Type

☐ 18 Full Length Fixed Height Conventional - No Charge
☐ 19 Full Length Adj. Height Conventional - $69.62 ea. or $139.24 set E0973
☐ 28 Desk Length Fixed Height Conventional - No Charge
☐ 29 Desk Length Adj. Height Conventional - $69.62 ea. or $139.24 set E0973

Back Type

☐ BH16 Back Height 16" Fixed Standard

Color Options

Upholstery Colors

☐ U240 Black Nylon Upholstery - No Charge
☐ U550 Midnight Blue Vinyl Upholstery - No Charge
☐ U67 Black Vinyl - Standard
☐ U86 Ruby Red Vinyl - No Charge

Caster and Wheel Options

Caster Options

☐ 1228 8" x 1.75" Semi-Pneu. Casters Lt Grey - $59.98
☐ AT903 8" x 1.25" Composite Urethane - Standard
☐ 1290 8" x 1" Solid Rubber Caster - Charcoal - No Charge

Wheel Options

☐ 5244BK 24" Heavy Duty Comp. Pneu. with FF Inserts - $319.16 E2211+E2213 (Only available with 1228 for Heavy Duty 450 lbs. weight capacity.)
☐ U2222C 24" Composite Urethane Corded Tires - Standard

Handrim Options

☐ BHDRM Black Handrims - Standard

Wheel Locks

☐ 9690B Pull To Lock Wheel Locks (Std on Hemi) - No Charge
☐ 9691B Push To Lock Wheel Locks (Std on Adult) - No Charge

Positioning Strap Options

Seat Positioning Straps

☐ 1515 Push Button Style Positioning Strap - $53.55 E0978
☐ 1321BK Hook and Loop Seat Positioning Strap - $42.84 E0978

Accessories

Back Accessories

☐ L8601 Omit Back Upholstery - Less $10.00
☐ 1160 Carrying Pocket - $57.83
☐ STC Stencil Back Upholstery (3/4" block letters) - $31.06

Arm Accessories

☐ NRAS Non Removable Arm with Screws - $10.71

Seat Accessories

☐ L8651 Omit Seat Upholstery - Less $10.00
☐ 9120 Solid Seat Insert - $104.96 (Only available with U67 Upholstery.)

Miscellaneous Accessories

☐ 1329BK Toggle Wheel Lock Extension (8") - $41.77 E0961
☐ 1335 Non-Folding Device - $42.84 K0108
☐ MUPH Matching Upholstery - No Charge
☐ 1715 Single Pole Overhead Anti Theft Device - $49.27
☐ 1305L Crutch and Cane Carrier - $46.05 E2207

Front Rigging Options

Front Riggings

☐ T93HAB Hemi Bolt-Thru Footrests, Aluminum Footplates - $95.93
☐ T94HAB Hemi Bolt-Thru Legrests, Aluminum Footplates - $186.53
☐ AHL4C Hemi Smartleg Articulating Legrests, Composite Footplates - $319.77 K0053
☐ AHL4A Hemi Smartleg Articulating Legrests, Aluminum Footplates - $341.09 K0053

Footplates Type

☐ 1350 Extra Large Aluminum Footplates - $84.21 K0041

Footrest/Legrest Accessories

☐ 1820 Non-Removable Device - $12.79
☐ 1337 Calf Strap - $38.37 K0038
☐ 1346 Heel Loops - $41.57 E0951 (Standard on Swingaway Footrests T93HA and T93HC.)

Seat to Floor Height and Caster Information

SEAT-TO-FLOOR HEIGHT	FRONT CASTER MOUNTING POSITION	REAR WHEEL SIZE	REAR WHEEL MOUNTING POSITION
17.5"	Top	24"	Top
19.5"	Bottom	24"	Bottom

Weight Limitation: 350 lbs. or 450 lbs. (with upgraded casters and wheels)

Invacare recommends all wheelchairs to be fitted to the consumer under the guidance of a healthcare professional knowledgeable of the particular limitations of the product.

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