How To Use HCPCS Code E2295

HCPCS code E2295 describes a manual wheelchair accessory specifically designed for pediatric size wheelchairs. This accessory is known as a dynamic seating frame, which allows coordinated movement of multiple positioning features. In this article, we will explore the details of HCPCS code E2295, 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 E2295?

HCPCS code E2295 is used to identify a manual wheelchair accessory that is intended for pediatric size wheelchairs. This accessory is a dynamic seating frame, which enables coordinated movement of multiple positioning features. It is designed to provide optimal support and comfort for pediatric patients who require a wheelchair for mobility.

2. Official Description

The official description of HCPCS code E2295 is “Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider should first ensure that the pediatric wheelchair is suitable for the installation of a dynamic seating frame.
2. The dynamic seating frame should be securely attached to the wheelchair according to the manufacturer’s instructions.
3. The provider should adjust the positioning features of the dynamic seating frame based on the individual needs of the pediatric patient.
4. Once the dynamic seating frame is properly installed and adjusted, the pediatric patient can use the wheelchair with the added benefits of the dynamic seating features.

4. When to use HCPCS code E2295

HCPCS code E2295 should be used when a healthcare provider supplies and installs a dynamic seating frame on a pediatric size wheelchair. This code is specifically for pediatric patients and should not be used for adult-sized wheelchairs or other types of seating frames.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2295, healthcare providers should ensure that the following documentation is included:

• A detailed description of the dynamic seating frame provided
• The pediatric patient’s medical records, including the need for the dynamic seating frame
• The manufacturer’s instructions for installation and adjustment of the seating frame
• An itemized invoice or receipt for the dynamic seating frame

Providers should also follow the billing guidelines set forth by the relevant insurance carriers and ensure that all necessary information is included in the claim submission.

6. Historical Information and Code Maintenance

HCPCS code E2295 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 E2295 is covered by Medicare. The pricing indicator code 57 indicates that the service or supply is priced by other carriers. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS priced under one methodology. Healthcare providers should consult the Medicare Carriers Manual Reference Section Number 2130, 4450 for further guidance on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code E2295 should be billed:

1. A pediatric patient with mobility limitations requires a manual wheelchair with a dynamic seating frame to support their positioning needs.
2. A healthcare provider supplies and installs a dynamic seating frame on a pediatric wheelchair for a patient with complex postural requirements.
3. A child with neuromuscular disorders needs a wheelchair with a dynamic seating frame to promote proper alignment and prevent pressure sores.
4. A pediatric patient with cerebral palsy requires a wheelchair with a dynamic seating frame to facilitate movement and improve their overall comfort.
5. A healthcare provider replaces a worn-out dynamic seating frame on a pediatric wheelchair to ensure the continued support and functionality for the patient.