How To Use HCPCS Code E0260

HCPCS code E0260 describes a semi-electric hospital bed with head and foot adjustment, equipped with any type of side rails and a mattress. This code is used to identify the specific type of hospital bed provided to patients who require medical care and assistance. In this article, we will explore the details of HCPCS code E0260, 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 E0260?

HCPCS code E0260 is used to identify a semi-electric hospital bed with head and foot adjustment, side rails, and a mattress. This code is specific to hospital beds and distinguishes them from other types of medical equipment. It is important to use this code accurately to ensure proper billing and reimbursement for the provided services.

2. Official Description

The official description of HCPCS code E0260 is “Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress.” The short description for this code is “Enteral supp not otherwise c.” These descriptions provide a clear understanding of the specific features and purpose of the hospital bed covered by this code.

3. Procedure

1. Ensure that the hospital bed being provided meets the criteria specified in the official description of HCPCS code E0260.
2. Set up the semi-electric hospital bed with proper adjustments for the head and foot.
3. Attach the appropriate type of side rails to ensure patient safety and prevent falls.
4. Place a mattress on the hospital bed to provide comfort and support for the patient.
5. Ensure that all components of the hospital bed are functioning properly before use.

4. When to use HCPCS code E0260

HCPCS code E0260 should be used when providing a semi-electric hospital bed with head and foot adjustment, side rails, and a mattress to patients who require medical care and assistance. This code is applicable for both inpatient and outpatient settings, as long as the specific criteria for this type of hospital bed are met.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0260, healthcare providers need to ensure that the documentation supports the medical necessity of providing a semi-electric hospital bed with the specified features. This may include the patient’s medical condition, the need for head and foot adjustment, side rails for safety, and the requirement for a mattress. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E0260 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 HCPCS.

7. Medicare and Insurance Coverage

HCPCS code E0260 is covered 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. Medicare and insurance providers may have specific coverage guidelines and reimbursement rates for this code, so it is important to verify the requirements with each individual payer.

8. Examples

Here are five examples of when HCPCS code E0260 should be billed:

1. A patient with limited mobility and medical needs requires a semi-electric hospital bed with head and foot adjustment, side rails, and a mattress for home use.
2. A hospital provides a semi-electric hospital bed with the specified features to an inpatient who requires assistance with positioning and comfort.
3. A skilled nursing facility supplies a semi-electric hospital bed with head and foot adjustment, side rails, and a mattress to a resident with medical conditions that necessitate specialized care.
4. A hospice agency provides a semi-electric hospital bed with the specified features to a terminally ill patient for end-of-life care and comfort.
5. A durable medical equipment supplier delivers a semi-electric hospital bed with head and foot adjustment, side rails, and a mattress to a patient recovering from surgery at their home.