How To Use HCPCS Code E2604

HCPCS code E2604 describes a skin protection wheelchair seat cushion that is 22 inches or greater in width, with any depth. This code is used to identify a specific type of wheelchair seat cushion that provides skin protection for individuals who use wheelchairs. It is important for medical coders to understand the meaning and usage of this code in order to accurately document and bill for the services provided.

1. What is HCPCS E2604?

HCPCS code E2604 is used to identify a skin protection wheelchair seat cushion that is 22 inches or greater in width, with any depth. This code specifically refers to a cushion that is designed to provide support and prevent pressure ulcers or skin breakdown for individuals who use wheelchairs. It is important to note that this code is specific to the dimensions of the seat cushion and does not include any additional features or accessories.

2. Official Description

The official description of HCPCS code E2604 is “Skin protection wheelchair seat cushion, width 22 inches or greater, any depth.” This description accurately defines the specific type of wheelchair seat cushion that is identified by this code. The short description for this code is “Enteral supp not otherwise c,” which provides a brief summary of the code’s purpose.

3. Procedure

  1. Measure the width of the wheelchair seat to determine if it is 22 inches or greater.
  2. Select a skin protection wheelchair seat cushion that is appropriate for the individual’s needs.
  3. Ensure that the seat cushion provides adequate support and pressure relief to prevent skin breakdown.
  4. Install the seat cushion onto the wheelchair seat, ensuring a secure fit.
  5. Instruct the individual on the proper use and maintenance of the seat cushion.

4. When to use HCPCS code E2604

HCPCS code E2604 should be used when documenting and billing for a skin protection wheelchair seat cushion that meets the specific dimensions of 22 inches or greater in width, with any depth. This code is applicable when providing support and preventing pressure ulcers or skin breakdown for individuals who use wheelchairs. It is important to ensure that the dimensions of the seat cushion match the requirements of this code in order to accurately bill for the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2604, healthcare providers should ensure that the following documentation is included:

  • A detailed description of the skin protection wheelchair seat cushion provided
  • The dimensions of the seat cushion, specifically indicating a width of 22 inches or greater
  • Documentation supporting the medical necessity of the seat cushion
  • Any additional documentation required by the payer or insurance company

6. Historical Information and Code Maintenance

HCPCS code E2604 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its addition to the HCPCS.

7. Medicare and Insurance Coverage

HCPCS code E2604 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. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code E2604 should be billed:

  1. A patient with a wheelchair seat that measures 24 inches in width requires a skin protection wheelchair seat cushion to prevent pressure ulcers.
  2. An individual with limited mobility who uses a wheelchair requires a skin protection wheelchair seat cushion that is 22 inches or greater in width to provide support and prevent skin breakdown.
  3. A healthcare facility provides a skin protection wheelchair seat cushion to a patient with a wheelchair seat that measures 26 inches in width.
  4. An individual with a history of pressure ulcers requires a skin protection wheelchair seat cushion that is 22 inches or greater in width to prevent further skin breakdown.
  5. A wheelchair user who spends a significant amount of time seated requires a skin protection wheelchair seat cushion that is 22 inches or greater in width to ensure comfort and prevent pressure ulcers.

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