HCPCS code E0118 describes a crutch substitute, specifically a lower leg platform, that may or may not have wheels. This code is used to identify the supply and is typically billed for each individual item provided. In this article, we will explore the details of HCPCS code E0118, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.
1. What is HCPCS E0118?
HCPCS code E0118 is used to identify a crutch substitute, specifically a lower leg platform. This device is designed to provide support and stability for individuals who have difficulty walking or standing for extended periods of time. The platform may or may not be equipped with wheels, depending on the specific model.
2. Official Description
The official description of HCPCS code E0118 is “Crutch substitute, lower leg platform, with or without wheels, each.” This description accurately reflects the purpose and features of the device.
3. Procedure
- Ensure that the patient meets the criteria for using a crutch substitute, such as having difficulty walking or standing.
- Select the appropriate lower leg platform based on the patient’s needs and preferences.
- If the platform has wheels, ensure that they are securely attached and in good working condition.
- Instruct the patient on how to properly use the lower leg platform for support and mobility.
- Provide any necessary adjustments or modifications to ensure a proper fit for the patient.
4. When to use HCPCS code E0118
HCPCS code E0118 should be used when providing a crutch substitute in the form of a lower leg platform. This code is applicable for patients who require support and stability for walking or standing but may not be able to use traditional crutches. It is important to ensure that the patient meets the criteria for using this device and that it is medically necessary for their condition.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code E0118, healthcare providers should ensure that the following documentation is included:
- A detailed description of the device provided, including whether it has wheels or not.
- The quantity of lower leg platforms provided.
- The date of service.
- The patient’s medical record, including documentation of the medical necessity for the device.
6. Historical Information and Code Maintenance
HCPCS code E0118 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. This suggests that the code has remained relatively stable since its addition to the system.
7. Medicare and Insurance Coverage
HCPCS code E0118 is covered by Medicare and other insurance carriers. The pricing indicator code 57 indicates that the code is priced by other carriers using their own methodology. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. Providers should verify coverage and reimbursement rates with the specific insurance carrier before billing for this service.
8. Examples
Here are five examples of when HCPCS code E0118 should be billed:
- A patient with a lower leg injury requiring support and stability while walking.
- An elderly individual with mobility issues who needs assistance with standing and walking.
- A post-surgical patient who is unable to use traditional crutches but still requires support for mobility.
- A patient with a chronic condition that affects their ability to walk or stand for extended periods of time.
- An individual with a temporary disability who needs assistance with mobility during their recovery.
