How To Use HCPCS Code E1816

HCPCS code E1816 describes a static progressive stretch ankle device that is used for flexion and/or extension of the ankle joint. This device includes all necessary components and accessories. It may also have the option for range of motion adjustment, allowing for customization based on the patient’s needs. This code falls under the category of enteral/parenteral nutrients/supplies, indicating its relevance in providing support for enteral feeding.

1. What is HCPCS E1816?

HCPCS code E1816 is specifically used to identify the static progressive stretch ankle device. This device is designed to assist in the rehabilitation of the ankle joint by providing controlled stretching and movement. It is commonly used in physical therapy settings to improve range of motion and flexibility in patients with ankle injuries or conditions.

2. Official Description

The official description of HCPCS code E1816 is “Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories.” The short description for this code is “Enteral supp not otherwise c.” This description accurately reflects the purpose and components of the device.

3. Procedure

1. The provider begins by assessing the patient’s ankle condition and determining the appropriate level of stretch and range of motion adjustment.
2. The static progressive stretch ankle device is then applied to the patient’s ankle, ensuring a secure and comfortable fit.
3. The provider adjusts the device to the desired level of flexion and/or extension, taking into account the patient’s comfort and tolerance.
4. The patient is instructed on how to use the device and perform exercises or movements while wearing it.
5. The provider may recommend a specific duration and frequency for wearing the device, depending on the patient’s condition and treatment goals.
6. Regular follow-up appointments are scheduled to monitor the patient’s progress and make any necessary adjustments to the device or treatment plan.

4. When to use HCPCS code E1816

HCPCS code E1816 should be used when a static progressive stretch ankle device is provided to a patient for the purpose of improving ankle flexibility and range of motion. This code is applicable for patients who require controlled stretching and movement of the ankle joint as part of their rehabilitation or treatment plan. It is important to ensure that the device meets the specific requirements outlined in the code description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E1816, healthcare providers should ensure that the following documentation is included:

• A detailed description of the device provided, including any specific features or adjustments
• The patient’s diagnosis or condition necessitating the use of the device
• The duration and frequency of device usage recommended by the provider
• Any additional services or supplies provided in conjunction with the device

Providers should also follow the appropriate billing guidelines and requirements set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E1816 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. No maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code. This code falls under the category of enteral/parenteral nutrients/supplies, indicating its relevance in providing support for enteral feeding.

7. Medicare and Insurance Coverage

HCPCS code E1816 is covered by Medicare and may be eligible for reimbursement. The pricing indicator code for this code is 57, which signifies that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for further guidance on coverage and reimbursement.

8. Examples

Here are some examples of when HCPCS code E1816 should be billed:

1. A patient with a history of ankle injury undergoes physical therapy and is provided with a static progressive stretch ankle device to improve ankle flexibility and range of motion.
2. An individual with a chronic ankle condition requires ongoing use of a static progressive stretch ankle device to maintain ankle mobility and prevent further deterioration.
3. A post-surgical patient is prescribed a static progressive stretch ankle device as part of their rehabilitation program to aid in the recovery and restoration of ankle function.
4. A professional athlete sustains an ankle injury and utilizes a static progressive stretch ankle device during their recovery process to expedite healing and regain optimal performance.
5. A patient with a neurological condition that affects ankle movement receives a static progressive stretch ankle device to assist in improving their mobility and overall quality of life.