How To Use HCPCS Code E2395

HCPCS code E2395 describes a power wheelchair accessory, specifically a caster wheel, excluding the tire. This code is used for replacement purposes only, and it is important for medical coders to understand its meaning and usage in order to accurately bill for this particular item.

1. What is HCPCS E2395?

HCPCS code E2395 is used to identify a specific power wheelchair accessory, which is the caster wheel. It is important to note that this code excludes the tire and is intended for replacement purposes only. The caster wheel is an essential component of a power wheelchair, providing stability and maneuverability for the user.

2. Official Description

The official description of HCPCS code E2395 is “Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each.” The short description for this code is “Enteral supp not otherwise c.” This description clearly indicates that this code is specifically for the replacement of the caster wheel of a power wheelchair, excluding the tire.

3. Procedure

1. When replacing the caster wheel of a power wheelchair, the healthcare provider should ensure that the new wheel is compatible with the wheelchair model.
2. Remove the old caster wheel by loosening the bolts or screws that secure it to the wheelchair frame.
3. Inspect the replacement caster wheel for any defects or damage before installation.
4. Align the replacement caster wheel with the designated mounting area on the wheelchair frame.
5. Tighten the bolts or screws to securely attach the new caster wheel to the wheelchair frame.
6. Test the wheelchair to ensure proper functionality and stability of the new caster wheel.

4. When to use HCPCS code E2395

HCPCS code E2395 should be used when a power wheelchair requires a replacement caster wheel. It is important to note that this code is not applicable for initial wheelchair purchases or for situations where the entire wheelchair needs to be replaced. It is specifically for the replacement of the caster wheel only.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2395, healthcare providers should ensure that the following documentation is included:

• Documentation supporting the medical necessity for the replacement caster wheel.
• Proof of the wheelchair model and the need for a replacement caster wheel.
• Itemized invoice or receipt for the replacement caster wheel.

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

6. Historical Information and Code Maintenance

HCPCS code E2395 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 coding system.

7. Medicare and Insurance Coverage

HCPCS code E2395 is covered by Medicare and other insurance carriers. The pricing indicator code 57 indicates that this code is priced by carriers other than Medicare. The multiple pricing indicator code A signifies that this code is not applicable for pricing under multiple methodologies.

8. Examples

Here are some examples of when HCPCS code E2395 should be billed:

1. A patient’s power wheelchair requires a replacement caster wheel due to wear and tear.
2. A power wheelchair is damaged in an accident, and the caster wheel needs to be replaced.
3. A power wheelchair user experiences a malfunction in the existing caster wheel, necessitating a replacement.
4. During a routine maintenance check, it is determined that the caster wheel of a power wheelchair needs to be replaced.
5. A power wheelchair user requests an upgrade to a different type of caster wheel, and the replacement is deemed medically necessary.