How To Use HCPCS Code E0165

HCPCS code E0165 describes a commode chair that is either mobile or stationary, with detachable arms. This code is used to identify the specific type of equipment that is being provided to a patient. In this article, we will explore the details of HCPCS code E0165, 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 E0165?

HCPCS code E0165 is used to identify a commode chair that can be either mobile or stationary, and has detachable arms. This code is specific to this type of equipment and is used to ensure accurate billing and reimbursement for the provider.

2. Official Description

The official description of HCPCS code E0165 is “Commode chair, mobile or stationary, with detachable arms.” The short description for this code is “Enteral supp not otherwise c.” This description provides a clear understanding of the equipment being referred to by this code.

3. Procedure

1. When providing a commode chair to a patient, ensure that it meets the specifications outlined in HCPCS code E0165.
2. If the commode chair is mobile, ensure that it is equipped with wheels or other means of mobility.
3. If the commode chair is stationary, ensure that it is designed to be used in a fixed location.
4. Detach the arms of the commode chair if they are not required for the patient’s comfort or mobility.
5. Ensure that the commode chair is properly cleaned and maintained to meet hygiene standards.

4. When to use HCPCS code E0165

HCPCS code E0165 should be used when providing a commode chair to a patient. This code is applicable when the chair is either mobile or stationary, and has detachable arms. It is important to use this code accurately to ensure proper billing and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0165, healthcare providers need to document the provision of the commode chair and any relevant details. This may include the patient’s medical condition or need for the chair, the duration of use, and any other pertinent information. It is important to follow the billing guidelines set forth by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E0165 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 code has remained unchanged since its addition to the system.

7. Medicare and Insurance Coverage

HCPCS code E0165 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 further guidance on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code E0165 should be billed:

1. A patient with limited mobility requires a commode chair with detachable arms for use in their home.
2. A healthcare facility provides a mobile commode chair with detachable arms for a patient recovering from surgery.
3. An elderly patient requires a stationary commode chair with detachable arms to assist with toileting.
4. A hospice provider supplies a mobile commode chair with detachable arms to a patient in their care.
5. A rehabilitation center provides a stationary commode chair with detachable arms for a patient undergoing physical therapy.