How To Use HCPCS Code E0111

HCPCS code E0111 describes a crutch forearm, which includes crutches of various materials, adjustable or fixed, each, with tip and handgrips. This code is used to identify and bill for the provision of crutches to patients who require assistance with mobility due to injury, disability, or other medical conditions.

1. What is HCPCS E0111?

HCPCS code E0111 is specifically used to identify and bill for crutch forearm supplies. These supplies typically consist of crutches made from different materials, such as aluminum or wood, and can be adjustable or fixed in nature. Each set of crutches includes tips and handgrips to ensure proper support and stability for the patient.

2. Official Description

The official description of HCPCS code E0111 is “Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. When providing crutches to a patient, the healthcare provider should assess the patient’s specific needs and determine the appropriate type of crutches required.
2. The provider should select crutches made from suitable materials, such as aluminum or wood, based on the patient’s weight, height, and mobility requirements.
3. If adjustable crutches are chosen, the provider should ensure that they are properly adjusted to the patient’s height and arm length for optimal support.
4. The provider should provide the patient with tips and handgrips that are securely attached to the crutches to prevent slipping and ensure a comfortable grip.
5. Proper instructions on how to use the crutches should be given to the patient, including how to maintain balance, walk, and navigate stairs or uneven surfaces.

4. When to use HCPCS code E0111

HCPCS code E0111 should be used when providing crutch forearm supplies to patients who require assistance with mobility. This code is applicable for various medical conditions, injuries, or disabilities that affect a patient’s ability to walk or bear weight on their lower extremities. It is important to ensure that the patient meets the eligibility criteria for using this code, such as having a medical necessity for crutches and a prescription from a healthcare provider.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0111, healthcare providers should ensure that the following documentation requirements are met:

• A prescription or order from a healthcare provider specifying the need for crutches
• Documentation of the patient’s medical condition or injury that necessitates the use of crutches
• Date of service and duration of crutch usage, if applicable
• Any additional supporting documentation, such as medical records or progress notes

6. Historical Information and Code Maintenance

HCPCS code E0111 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code E0111 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines on billing and reimbursement for this code.

8. Examples

Here are five examples of scenarios where HCPCS code E0111 would be used:

1. A patient with a fractured leg requires crutches for mobility during the healing process.
2. An individual with a chronic condition affecting their lower extremities needs crutches to assist with walking and maintaining balance.
3. A post-surgical patient is prescribed crutches to aid in their recovery and prevent weight-bearing on the affected leg.
4. A person with a temporary disability, such as a sprained ankle, requires crutches for a limited period until they regain full mobility.
5. A patient with a permanent disability relies on crutches as their primary means of mobility.