How To Use HCPCS Code E0971

HCPCS code E0971 describes a manual wheelchair accessory known as an anti-tipping device. This code is used to identify and bill for the provision of this specific wheelchair accessory. In this article, we will explore the details of HCPCS code E0971, 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 E0971?

HCPCS code E0971 is used to identify a manual wheelchair accessory, specifically an anti-tipping device. This device is designed to prevent the wheelchair from tipping over, providing stability and safety for the user. It is typically attached to the rear of the wheelchair and helps to distribute weight evenly, reducing the risk of tipping.

2. Official Description

The official description of HCPCS code E0971 is “Manual wheelchair accessory, anti-tipping device, each.” This description accurately reflects the purpose and function of the accessory. The short description for this code is “Enteral supp not otherwise c,” which may be confusing as it does not directly relate to the anti-tipping device. However, it is important to note that HCPCS codes can sometimes have multiple uses or be associated with different types of equipment or supplies.

3. Procedure

1. Ensure that the manual wheelchair is compatible with an anti-tipping device.
2. Select the appropriate anti-tipping device based on the wheelchair model and specifications.
3. Attach the anti-tipping device securely to the rear of the wheelchair according to the manufacturer’s instructions.
4. Test the device to ensure proper functionality and stability.
5. Instruct the wheelchair user on the proper use and maintenance of the anti-tipping device.

4. When to use HCPCS code E0971

HCPCS code E0971 should be used when providing a manual wheelchair accessory in the form of an anti-tipping device. This code is applicable when the anti-tipping device is separately billed or when it is included as part of a bundled service or supply. It is important to review the specific coverage guidelines and requirements of the payer to determine the appropriate use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0971, healthcare providers should ensure that the following documentation is included:

• A detailed description of the anti-tipping device provided, including the manufacturer, model, and any unique features.
• The date of service when the device was provided.
• The patient’s medical record, indicating the medical necessity for the anti-tipping device.
• Any supporting documentation, such as a prescription or order from a healthcare professional.

Providers should follow the appropriate billing guidelines and requirements of the payer, including any specific modifiers or additional documentation that may be necessary.

6. Historical Information and Code Maintenance

HCPCS code E0971 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 since its addition to the system.

7. Medicare and Insurance Coverage

HCPCS code E0971 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 57 indicates that the service or supply associated with this code is priced by other carriers. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for additional guidance on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code E0971 should be billed:

1. A patient with a manual wheelchair requires an anti-tipping device to enhance stability and prevent accidents.
2. A healthcare facility purchases anti-tipping devices in bulk to provide them to multiple wheelchair users.
3. A wheelchair user’s existing anti-tipping device becomes damaged and needs to be replaced.
4. A wheelchair user is prescribed an anti-tipping device by their healthcare provider due to a specific medical condition that increases the risk of tipping.
5. A manual wheelchair is being customized for a patient, and the addition of an anti-tipping device is requested by the patient or their caregiver.