How To Use HCPCS Code E0117

HCPCS code E0117 describes a specific type of crutch known as an underarm, articulating, spring-assisted crutch. This code is used to identify and bill for the provision of this particular type of crutch, which is designed to provide support and assistance to individuals with mobility issues. In this article, we will explore the details of HCPCS code E0117, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS E0117?

HCPCS code E0117 is used to identify a specific type of crutch known as an underarm, articulating, spring-assisted crutch. This type of crutch is designed to provide support and assistance to individuals with mobility issues. It features articulating arms and a spring-assisted mechanism, which helps to reduce the strain on the user’s arms and shoulders while walking. The code E0117 is used to accurately document and bill for the provision of this particular type of crutch.

2. Official Description

The official description of HCPCS code E0117 is “Crutch, underarm, articulating, spring assisted, each.” This description accurately reflects the specific features and characteristics of the crutch that this code represents. The short description of this code is “Enteral supp not otherwise c,” which indicates that it is not related to enteral support services.

3. Procedure

1. The provider assesses the patient’s mobility needs and determines if the use of an underarm, articulating, spring-assisted crutch is appropriate.
2. If the provider determines that the use of this specific type of crutch is necessary, they prescribe it to the patient.
3. The patient or their caregiver obtains the crutch from a durable medical equipment supplier.
4. The supplier ensures that the crutch is properly fitted to the patient’s height and provides instructions on how to use it.
5. The patient uses the crutch as instructed, receiving the necessary support and assistance for their mobility needs.

4. When to use HCPCS code E0117

HCPCS code E0117 should be used when a healthcare provider prescribes and provides an underarm, articulating, spring-assisted crutch to a patient. This code is specific to this type of crutch and should not be used for other types of crutches or mobility aids. It is important to ensure that the patient meets the eligibility criteria for the use of this specific crutch before using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0117, healthcare providers need to document the medical necessity for the use of this specific type of crutch. This documentation should include the patient’s diagnosis, the provider’s prescription, and any other relevant information supporting the need for the underarm, articulating, spring-assisted crutch. Additionally, providers should follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E0117 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition. The code remains unchanged and continues to be used to identify the underarm, articulating, spring-assisted crutch.

7. Medicare and Insurance Coverage

HCPCS code E0117 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 57 indicates that the pricing for this code is determined by other carriers. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidance on coverage and reimbursement for HCPCS code E0117.

8. Examples

Here are five examples of when HCPCS code E0117 should be billed:

1. A patient with a lower limb injury requires the use of an underarm, articulating, spring-assisted crutch to assist with mobility during the healing process.
2. An individual with a chronic condition that affects their balance and stability needs the support of an underarm, articulating, spring-assisted crutch to safely navigate their daily activities.
3. A post-surgical patient is prescribed an underarm, articulating, spring-assisted crutch to aid in their recovery and rehabilitation.
4. A person with a temporary mobility impairment due to a sprained ankle relies on an underarm, articulating, spring-assisted crutch to maintain their mobility while their injury heals.
5. An elderly individual with age-related mobility limitations uses an underarm, articulating, spring-assisted crutch to maintain their independence and safely move around their home.