How To Use HCPCS Code E1229

HCPCS code E1229 describes a pediatric-sized wheelchair that is not otherwise specified. This code is used to identify the specific type of wheelchair being provided to a pediatric patient. In this article, we will explore the details of HCPCS code E1229, 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 E1229?

HCPCS code E1229 is used to identify a pediatric-sized wheelchair that is not otherwise specified. This code is specifically used for enteral supplies that are not otherwise classified. It is important to note that this code is only applicable for pediatric patients and should not be used for adult-sized wheelchairs or other types of medical equipment.

2. Official Description

The official description of HCPCS code E1229 is “Wheelchair, pediatric size, not otherwise specified.” This description accurately reflects the purpose and usage of this specific code. The short description for this code is “Enteral supp not otherwise c,” which further clarifies that it is used for enteral supplies that are not otherwise classified.

3. Procedure

1. When providing a pediatric-sized wheelchair, ensure that it meets the specific requirements for this code.
2. Verify that the wheelchair is intended for enteral use and not for other purposes.
3. Document the details of the wheelchair, including its size and any specific features or modifications.
4. Submit the appropriate claim with HCPCS code E1229 to accurately reflect the provision of a pediatric-sized wheelchair.

4. When to use HCPCS code E1229

HCPCS code E1229 should be used when providing a pediatric-sized wheelchair that is not otherwise specified. This code is specifically for enteral supplies, so it should only be used when the wheelchair is intended for enteral use. It is important to ensure that the wheelchair meets the specific requirements outlined in the code description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E1229, healthcare providers should ensure that the necessary documentation is in place to support the provision of a pediatric-sized wheelchair. This may include documentation of the patient’s age, the need for a pediatric-sized wheelchair, and any specific features or modifications required. Providers should also follow the billing guidelines set forth by the relevant payers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E1229 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 to the code since its addition.

7. Medicare and Insurance Coverage

HCPCS code E1229 is covered by Medicare and other insurance providers. The pricing indicator code 57 indicates that this code is priced by other carriers. The multiple pricing indicator code A indicates that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific coverage instructions and guidelines.

8. Examples

Here are some examples of when HCPCS code E1229 should be billed:

1. A pediatric patient requires a wheelchair for enteral use, and the specific size and features of the wheelchair are not otherwise specified.
2. A healthcare provider supplies a pediatric-sized wheelchair to a patient with specific enteral needs, and the wheelchair meets the requirements outlined in HCPCS code E1229.
3. A pediatric patient requires a wheelchair for enteral use, and the provider documents the provision of a pediatric-sized wheelchair with the necessary modifications.
4. A healthcare provider bills for the provision of a pediatric-sized wheelchair that meets the requirements of HCPCS code E1229 for a patient with enteral needs.
5. A pediatric patient receives a wheelchair that is not otherwise specified for enteral use, and the provider accurately bills with HCPCS code E1229.