HCPCS code E0992 describes a manual wheelchair accessory known as a solid seat insert. 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 E0992, 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 E0992?
HCPCS code E0992 is used to identify a manual wheelchair accessory called a solid seat insert. This accessory is designed to provide additional support and stability to the seat of a manual wheelchair. It is typically made of a rigid material and is inserted into the seat of the wheelchair to create a solid and stable surface for the user.
2. Official Description
The official description of HCPCS code E0992 is “Manual wheelchair accessory, solid seat insert.” This description accurately reflects the purpose and function of this wheelchair accessory. The short description for this code is “Parenteral supp not othrws c,” which indicates that this code is not related to parenteral support services.
3. Procedure
- Prepare the manual wheelchair by removing any existing seat cushion or insert.
- Position the solid seat insert in the seat of the wheelchair, ensuring that it fits securely and covers the entire seating area.
- Secure the solid seat insert in place using the appropriate fastening mechanism, such as straps or Velcro.
- Ensure that the solid seat insert is properly aligned and provides the desired level of support and stability for the wheelchair user.
- Instruct the wheelchair user on the proper use and maintenance of the solid seat insert.
4. When to use HCPCS code E0992
HCPCS code E0992 should be used when providing a solid seat insert as a manual wheelchair accessory. This code is specifically for solid seat inserts and should not be used for other types of wheelchair accessories or supplies. It is important to ensure that the solid seat insert meets the specific needs and requirements of the wheelchair user before using this code for billing purposes.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code E0992, healthcare providers should ensure that the following documentation is included:
- A detailed description of the solid seat insert provided, including the brand, model, and specifications.
- Documentation supporting the medical necessity of the solid seat insert for the individual patient.
- The date of service and the duration of use, if applicable.
- Any additional documentation required by the payer or insurance company.
6. Historical Information and Code Maintenance
HCPCS code E0992 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 still in use and has not been terminated or replaced by any other code.
7. Medicare and Insurance Coverage
HCPCS code E0992 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 that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130, 4450 for specific guidelines and instructions on billing and coverage for HCPCS code E0992.
8. Examples
Here are five examples of when HCPCS code E0992 should be billed:
- A patient with a manual wheelchair requires a solid seat insert for additional support due to a spinal cord injury.
- An elderly individual with limited mobility needs a solid seat insert to improve their sitting posture and prevent pressure sores.
- A child with a developmental disability requires a solid seat insert to enhance their stability and comfort while using a manual wheelchair.
- A patient recovering from a lower limb surgery needs a solid seat insert to maintain proper alignment and support during the healing process.
- An individual with a degenerative condition such as muscular dystrophy requires a solid seat insert to compensate for muscle weakness and maintain an upright position in their wheelchair.
