How To Use HCPCS Code E1003

HCPCS code E1003 describes a specific wheelchair accessory known as a power seating system with recline functionality. This accessory is designed to provide individuals with enhanced comfort and support while using a wheelchair. It does not include shear reduction capabilities, which refers to the ability to minimize friction and pressure on the user’s skin.

1. What is HCPCS E1003?

HCPCS code E1003 is used to identify a power seating system for wheelchairs that offers recline functionality. This code is specifically for accessories that do not have shear reduction capabilities. It is important to note that this code is not applicable for other types of wheelchair accessories or components.

2. Official Description

The official description of HCPCS code E1003 is “Wheelchair accessory, power seating system, recline only, without shear reduction.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. Ensure that the power seating system is compatible with the specific wheelchair model.
2. Install the power seating system according to the manufacturer’s instructions.
3. Verify that the recline functionality is working properly.
4. Educate the wheelchair user on how to operate the power seating system safely.
5. Provide any necessary maintenance instructions to the user or caregiver.

4. When to use HCPCS code E1003

HCPCS code E1003 should be used when a healthcare provider or supplier is providing a power seating system with recline functionality for a wheelchair. It is important to ensure that the accessory being billed matches the specific description of the code, which excludes shear reduction capabilities.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E1003, healthcare providers should include the following documentation:

• A detailed description of the power seating system provided, including the manufacturer and model number.
• The date of service when the accessory was provided to the patient.
• Any relevant medical records or notes indicating the medical necessity of the power seating system.

Providers should follow the appropriate billing guidelines and submit the claim with the correct HCPCS code and any required modifiers, if applicable.

6. Historical Information and Code Maintenance

HCPCS code E1003 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 since its addition.

7. Medicare and Insurance Coverage

HCPCS code E1003 is covered by Medicare. The pricing indicator code 57 indicates that the service or supply is priced by other carriers using their own methodologies. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS is priced under one methodology.

8. Examples

Here are five examples of scenarios where HCPCS code E1003 should be billed:

1. A patient with a spinal cord injury requires a power seating system with recline functionality to alleviate pressure and provide comfort during extended periods of wheelchair use.
2. An individual with a degenerative condition needs a power seating system that allows them to adjust the recline angle for optimal positioning and pain management.
3. A wheelchair user with limited mobility requires a power seating system with recline functionality to prevent muscle stiffness and promote blood circulation.
4. A patient recovering from a surgical procedure relies on a wheelchair and requires a power seating system that offers recline capabilities to facilitate rest and recovery.
5. An elderly individual with mobility limitations needs a power seating system with recline functionality to reduce the risk of pressure ulcers and improve overall comfort.