How To Use HCPCS Code E0116

HCPCS code E0116 describes a specific type of crutch known as an underarm crutch. This code is used to identify adjustable or fixed underarm crutches that are made of materials other than wood. These crutches come with a pad, tip, handgrip, and may or may not have a shock absorber. Each crutch is considered a separate unit and is billed individually.

1. What is HCPCS E0116?

HCPCS code E0116 is used to identify underarm crutches that are adjustable or fixed, made of materials other than wood, and come with a pad, tip, handgrip, and shock absorber. Each crutch is billed individually, and this code is used to specify the type of crutch being provided.

2. Official Description

The official description of HCPCS code E0116 is “Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each.” The short description is “Parenteral supp not othrws c.”

3. Procedure

1. Adjustable or fixed underarm crutches are provided to the patient.
2. The crutches are made of materials other than wood.
3. A pad is attached to provide comfort and support under the arm.
4. A tip is attached to the bottom of the crutch for stability and traction.
5. A handgrip is provided for the patient to hold onto while using the crutches.
6. Some crutches may also have a shock absorber to reduce impact on the patient’s body.
7. Each crutch is considered a separate unit and is billed individually.

4. When to use HCPCS code E0116

HCPCS code E0116 should be used when providing underarm crutches that meet the specific criteria described in the official description. These crutches are used to assist patients with mobility and provide support while walking or standing. It is important to ensure that the crutches provided meet the requirements outlined in the code description to accurately bill for the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0116, healthcare providers should ensure that the following documentation is included:

• Documentation supporting the medical necessity of the crutches
• Date of service
• Number of units billed (each crutch is considered a separate unit)
• Provider’s name and credentials
• Patient’s name and identification number
• Any additional supporting documentation as required by the payer

6. Historical Information and Code Maintenance

HCPCS code E0116 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. No maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code. The code is still active and can be used for billing purposes.

7. Medicare and Insurance Coverage

HCPCS code E0116 is eligible for coverage under Medicare. 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 further guidance on billing and coverage for this code.

8. Examples

Here are five examples of when HCPCS code E0116 should be billed:

1. A patient with a lower limb injury requires underarm crutches for mobility support.
2. A post-operative patient needs underarm crutches to assist with walking during the recovery period.
3. An elderly individual with balance issues is prescribed underarm crutches to prevent falls.
4. A patient with a chronic condition that affects their ability to walk independently requires underarm crutches for daily use.
5. A physical therapist recommends underarm crutches as part of a rehabilitation program for a patient recovering from a leg injury.