HCPCS code E0959 describes a manual wheelchair accessory known as an adapter for amputees. This code is used to identify a specific device that is used to modify a manual wheelchair to accommodate individuals with amputations. It is important for medical coders to understand the meaning and usage of this code in order to accurately bill for the services provided.
1. What is HCPCS E0959?
HCPCS code E0959 is a specific code that is used to identify a manual wheelchair accessory known as an adapter for amputees. This accessory is designed to be attached to a manual wheelchair in order to provide additional support and stability for individuals with amputations. It is important to note that this code specifically refers to the adapter for amputees and not the manual wheelchair itself.
2. Official Description
The official description of HCPCS code E0959 is “Manual wheelchair accessory, adapter for amputee, each.” This description accurately reflects the purpose and function of the device. The short description for this code is “Parenteral supp not othrws c,” which provides additional clarification regarding the nature of the accessory.
3. Procedure
- The provider should first assess the individual’s needs and determine if an adapter for amputees is necessary.
- If it is determined that the individual requires an adapter for amputees, the provider should select the appropriate device based on the individual’s specific needs and the compatibility with their manual wheelchair.
- The provider should then attach the adapter to the manual wheelchair according to the manufacturer’s instructions.
- Once the adapter is securely attached, the provider should ensure that it is properly adjusted to provide the necessary support and stability for the individual.
- The provider should educate the individual on how to properly use and maintain the adapter for amputees.
4. When to use HCPCS code E0959
HCPCS code E0959 should be used when an individual requires a manual wheelchair accessory specifically designed for amputees. This code should only be used when the adapter for amputees is being provided as a separate accessory and not as part of the manual wheelchair itself. It is important to accurately document the need for the adapter and the specific amputation that it is intended to address.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code E0959, healthcare providers should ensure that the following documentation is included:
- A detailed description of the adapter for amputees and its purpose in addressing the individual’s specific needs.
- Documentation of the individual’s amputation and the need for the adapter.
- The date the adapter was provided and attached to the manual wheelchair.
- Any additional information or documentation required by the payer.
6. Historical Information and Code Maintenance
HCPCS code E0959 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 is priced by other carriers, as indicated by the pricing indicator code 57. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology.
7. Medicare and Insurance Coverage
HCPCS code E0959 is eligible for coverage by Medicare. However, it is important to note that coverage may vary depending on the specific circumstances and the individual’s insurance plan. Providers should consult the Medicare Carriers Manual Reference Section Number 2130 for additional guidance on coverage and reimbursement for this code.
8. Examples
Here are five examples of when HCPCS code E0959 should be billed:
- A patient with a below-the-knee amputation requires an adapter for amputees to provide additional support and stability while using a manual wheelchair.
- An individual with an above-the-knee amputation needs an adapter for amputees to modify their manual wheelchair for improved mobility.
- A patient with a bilateral lower limb amputation requires two adapters for amputees to accommodate their specific needs.
- An individual with an upper limb amputation needs an adapter for amputees to enhance their ability to self-propel their manual wheelchair.
- A patient with a partial foot amputation requires an adapter for amputees to ensure proper positioning and support while using a manual wheelchair.
