How To Use HCPCS Code E2385

HCPCS code E2385 describes a power wheelchair accessory, specifically a tube for a pneumatic caster tire. This code is used for replacement purposes only and applies to any size of tube. It falls under the category of enteral supplies and is not otherwise classified. In this article, we will explore the details of HCPCS code E2385, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS E2385?

HCPCS code E2385 is a specific code used to identify a power wheelchair accessory, which is a tube designed for a pneumatic caster tire. This code is used solely for replacement purposes and can be applied to tubes of any size. It is important to note that this code is specific to enteral supplies and is not applicable to other types of medical equipment or services.

2. Official Description

The official description of HCPCS code E2385 is “Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each.” This description clearly outlines the nature of the accessory, its purpose, and the specific circumstances in which it should be used. The short description for this code is “Enteral supp not otherwise c,” which further emphasizes its classification as an enteral supply.

3. Procedure

1. When replacing a tube for a pneumatic caster tire on a power wheelchair, ensure that the replacement tube is compatible with the specific tire size.
2. Remove the old tube from the tire by deflating it and carefully detaching it from the wheel.
3. Inspect the tire and wheel for any damage or wear that may require additional repairs or replacements.
4. Insert the new tube into the tire, ensuring that it is properly aligned and positioned.
5. Inflate the tube to the recommended pressure level, taking care not to overinflate or underinflate.
6. Secure the tube in place by reattaching the tire to the wheel and ensuring a tight fit.
7. Test the wheelchair to ensure proper functionality and tire performance.

4. When to use HCPCS code E2385

HCPCS code E2385 should be used when replacing a tube for a pneumatic caster tire on a power wheelchair. It is important to note that this code is applicable only for replacement purposes and cannot be used for initial installations or other types of wheelchair accessories. Providers should ensure that the replacement tube is necessary and meets the specific requirements of the wheelchair model and tire size.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2385, healthcare providers should ensure that the following documentation is in order:

• A detailed description of the replacement tube and its specifications.
• Documentation supporting the medical necessity of the replacement tube.
• Proof of the patient’s eligibility for power wheelchair accessories.
• Any additional documentation required by the payer or insurance provider.

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

6. Historical Information and Code Maintenance

HCPCS code E2385 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996, indicating that it has been in use for a considerable period of time. As indicated by the action code N, no maintenance actions have been taken for this code, meaning that there have been no updates or revisions since its addition.

7. Medicare and Insurance Coverage

HCPCS code E2385 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 57 indicates that the code is priced by carriers using methodologies other than the usual fee schedule. The multiple pricing indicator code A signifies that the code is not applicable for multiple pricing methodologies.

8. Examples

Here are five examples of scenarios in which HCPCS code E2385 should be billed:

1. A patient’s power wheelchair has a damaged tube for the pneumatic caster tire, requiring a replacement.
2. A power wheelchair user experiences a flat tire due to a puncture in the tube, necessitating a replacement.
3. During a routine maintenance check, it is discovered that the tube for the pneumatic caster tire on a power wheelchair is worn out and needs to be replaced.
4. A power wheelchair user accidentally runs over a sharp object, causing a puncture in the tube and requiring a replacement.
5. A tube for the pneumatic caster tire on a power wheelchair becomes brittle and cracks over time, necessitating a replacement.