How To Use HCPCS Code E2386

HCPCS code E2386 describes a power wheelchair accessory, specifically a foam-filled drive wheel tire. This code is used for replacement purposes only and applies to any size of foam-filled drive wheel tire. In this article, we will explore the details of HCPCS code E2386, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS E2386?

HCPCS code E2386 is a specific code used to identify a power wheelchair accessory, which is a foam-filled drive wheel tire. This code is used when a replacement of the foam-filled drive wheel tire is required. It is important to note that this code is applicable for any size of foam-filled drive wheel tire.

2. Official Description

The official description of HCPCS code E2386 is “Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure for HCPCS code E2386 involves the replacement of a foam-filled drive wheel tire for a power wheelchair.
2. The healthcare provider or technician will assess the condition of the existing foam-filled drive wheel tire.
3. If the tire is worn out, damaged, or no longer functional, the provider will remove the old tire.
4. A new foam-filled drive wheel tire will be selected based on the appropriate size for the power wheelchair.
5. The provider will then install the new foam-filled drive wheel tire onto the power wheelchair.
6. Finally, the provider will ensure that the new tire is securely attached and functioning properly.

4. When to use HCPCS code E2386

HCPCS code E2386 should be used when a replacement of the foam-filled drive wheel tire for a power wheelchair is necessary. This code is applicable for any size of foam-filled drive wheel tire. It is important to note that this code is specifically for replacement purposes only and should not be used for initial installations or other types of power wheelchair accessories.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2386, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation indicating the medical necessity for the replacement of the foam-filled drive wheel tire.
• Documentation specifying the size of the foam-filled drive wheel tire being replaced.
• Documentation supporting the need for a replacement rather than a repair.

Providers should also follow the appropriate billing guidelines set forth by the payer, ensuring accurate coding and submission of claims for reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E2386 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 since its addition to the HCPCS.

7. Medicare and Insurance Coverage

HCPCS code E2386 is covered by Medicare and other insurance carriers. 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, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of scenarios where HCPCS code E2386 should be billed:

1. A patient’s power wheelchair has a worn-out foam-filled drive wheel tire, and a replacement tire of the same size is needed.
2. A power wheelchair’s foam-filled drive wheel tire is damaged due to an accident, requiring a replacement tire of a different size.
3. A power wheelchair user experiences a flat tire on their foam-filled drive wheel tire and requires a replacement tire of the same size.
4. A power wheelchair’s foam-filled drive wheel tire is no longer functional, and a replacement tire of a larger size is necessary.
5. A patient’s power wheelchair has a foam-filled drive wheel tire that is beyond repair, necessitating a replacement tire of a smaller size.