How To Use HCPCS Code E2216

HCPCS code E2216 describes a manual wheelchair accessory known as a foam-filled propulsion tire. This code is used to identify and bill for the provision of a foam-filled tire that is used as a replacement or addition to a manual wheelchair. The code is applicable to tires of any size and is billed per tire.

1. What is HCPCS E2216?

HCPCS code E2216 is a specific code used in medical coding to identify and bill for the provision of a foam-filled propulsion tire for a manual wheelchair. This code is used when a healthcare provider supplies a foam-filled tire as an accessory to a manual wheelchair. The tire can be used as a replacement for an existing tire or as an additional tire for improved traction and durability.

2. Official Description

The official description of HCPCS code E2216 is “Manual wheelchair accessory, foam-filled propulsion tire, any size, each.” This description accurately reflects the purpose and nature of the code. The short description for this code is “Enteral supp not otherwise c,” which may seem unrelated to the actual product being described. However, it is important to note that HCPCS codes are used for a wide range of medical supplies and services, and the short description may not always directly correspond to the item being coded.

3. Procedure

1. When providing a foam-filled propulsion tire as a manual wheelchair accessory, the healthcare provider must ensure that the tire is compatible with the specific wheelchair model and size.
2. The existing tire on the manual wheelchair may need to be removed before the foam-filled tire can be installed. This can be done by releasing the tire from the wheel hub and carefully removing it.
3. The foam-filled tire should then be aligned with the wheel hub and securely attached. This can be done by aligning the tire’s valve stem with the valve hole on the wheel hub and tightening the bolts or screws to secure the tire in place.
4. Once the foam-filled tire is properly installed, the healthcare provider should ensure that it is inflated to the appropriate pressure. This can be done using a tire pump or inflator.
5. Finally, the healthcare provider should test the wheelchair with the new foam-filled tire to ensure that it functions properly and provides the desired traction and support.

4. When to use HCPCS code E2216

HCPCS code E2216 should be used when a healthcare provider supplies a foam-filled propulsion tire as an accessory to a manual wheelchair. This code is applicable when the tire is provided as a replacement for an existing tire or as an additional tire for improved traction and durability. It is important to note that this code is specific to foam-filled tires and should not be used for other types of wheelchair tires or accessories.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2216, healthcare providers should ensure that the following documentation is included:

• A detailed description of the foam-filled propulsion tire provided, including the size and any specific features or specifications.
• The date on which the tire was provided to the patient.
• The patient’s medical record, including any relevant information regarding the need for the foam-filled tire and its impact on the patient’s mobility and quality of life.
• Any supporting documentation, such as a prescription or referral, that indicates the medical necessity of the foam-filled tire.

When submitting the claim for reimbursement, healthcare providers should use the appropriate coding and billing systems, such as the Current Procedural Terminology (CPT) codes and the Healthcare Common Procedure Coding System (HCPCS) codes. The foam-filled propulsion tire should be billed per tire, using the specific HCPCS code E2216.

6. Historical Information and Code Maintenance

HCPCS code E2216 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code has an effective date of January 01, 1996, and has remained unchanged since then.

7. Medicare and Insurance Coverage

HCPCS code E2216 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. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for HCPCS code E2216.

8. Examples

Here are five examples of when HCPCS code E2216 should be billed:

1. A patient with a manual wheelchair requires a replacement foam-filled propulsion tire due to wear and tear.
2. A healthcare provider supplies an additional foam-filled tire to a patient’s manual wheelchair to improve traction and stability on uneven surfaces.
3. A manual wheelchair user requests a foam-filled tire as a personal preference for enhanced comfort and durability.
4. A patient with a medical condition that affects their mobility requires a foam-filled tire to ensure safe and efficient wheelchair propulsion.
5. A healthcare provider recommends a foam-filled tire as a preventive measure to reduce the risk of punctures or flats during outdoor activities.