How To Use HCPCS Code E0981

HCPCS code E0981 describes a wheelchair accessory, specifically seat upholstery, that is used as a replacement. This code is used to identify the specific item and its purpose in the healthcare setting. In this article, we will explore the details of HCPCS code E0981, 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 E0981?

HCPCS code E0981 is used to identify a wheelchair accessory, specifically seat upholstery, that is intended for replacement purposes. This code is important for medical coders and billers to accurately document and bill for this specific item.

2. Official Description

The official description of HCPCS code E0981 is “Wheelchair accessory, seat upholstery, replacement only, each.” The short description for this code is “Enteral supp not otherwise c.” It is crucial to use the exact descriptions provided to ensure accurate coding and billing.

3. Procedure

1. When replacing the seat upholstery of a wheelchair, remove the existing upholstery carefully.
2. Inspect the wheelchair frame and ensure it is in good condition.
3. Select the appropriate replacement seat upholstery that matches the specifications of the wheelchair.
4. Install the new seat upholstery onto the wheelchair frame, ensuring a secure fit.
5. Test the wheelchair to ensure proper functionality and comfort for the patient.

4. When to use HCPCS code E0981

HCPCS code E0981 should be used when replacing the seat upholstery of a wheelchair. It is important to note that this code is specific to replacement purposes only. If the seat upholstery is not being replaced, a different HCPCS code should be used to accurately represent the provided service or supply.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0981, healthcare providers need to document the need for seat upholstery replacement and provide supporting documentation, such as the patient’s medical records and any relevant prescriptions or orders. It is important to follow the specific billing guidelines set forth by Medicare or other insurance carriers to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E0981 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. The code has a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, meaning it is not applicable as HCPCS priced under one methodology. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code E0981 is eligible for coverage by Medicare. However, it is important to review the specific coverage instructions and guidelines provided by Medicare to ensure proper reimbursement. Other insurance carriers may also cover this code, but coverage policies may vary. It is essential to verify coverage with each individual insurance carrier to ensure accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code E0981 should be billed:

1. A patient’s wheelchair seat upholstery is worn out and needs to be replaced due to normal wear and tear.
2. A patient’s wheelchair seat upholstery is damaged and requires replacement due to an accident or incident.
3. A patient’s wheelchair seat upholstery is causing discomfort or pressure sores, necessitating replacement for improved patient comfort and health.
4. A patient’s wheelchair seat upholstery is no longer providing adequate support, requiring replacement to ensure proper positioning and stability.
5. A patient’s wheelchair seat upholstery is contaminated or soiled beyond repair, necessitating replacement for hygiene and infection control purposes.