How To Use HCPCS Code E2605

HCPCS code E2605 describes the positioning wheelchair seat cushion, specifically designed for wheelchairs with a width less than 22 inches and any depth. This code is used to identify the provision of enteral support that is not otherwise classified. It is important for medical coders to understand the specific meaning and usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS E2605?

HCPCS code E2605 is used to identify the positioning wheelchair seat cushion, which is designed for wheelchairs with a width less than 22 inches and any depth. This code specifically refers to the enteral support provided to patients who require assistance with positioning and comfort while using a wheelchair. It is important to note that this code is not applicable for other types of wheelchair seat cushions or for wheelchairs with a width greater than 22 inches.

2. Official Description

The official description of HCPCS code E2605 is “Positioning wheelchair seat cushion, width less than 22 inches, any depth.” The short description for this code is “Enteral supp not otherwise c.” This description accurately reflects the purpose and scope of this code, indicating that it is specifically used for enteral support in the form of a positioning wheelchair seat cushion.

3. Procedure

  1. Measure the width of the wheelchair seat to ensure it is less than 22 inches.
  2. Select an appropriate positioning wheelchair seat cushion that provides the necessary support and comfort for the patient.
  3. Position the wheelchair seat cushion on the wheelchair seat, ensuring proper alignment and fit.
  4. Secure the wheelchair seat cushion in place, following the manufacturer’s instructions.
  5. Ensure that the patient is comfortable and properly positioned on the wheelchair seat cushion.

4. When to use HCPCS code E2605

HCPCS code E2605 should be used when providing enteral support in the form of a positioning wheelchair seat cushion for patients who require assistance with positioning and comfort while using a wheelchair. It is important to ensure that the wheelchair has a width less than 22 inches and that the patient’s specific needs can be met with this type of seat cushion. This code should not be used for other types of wheelchair seat cushions or for wheelchairs with a width greater than 22 inches.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2605, healthcare providers need to document the provision of the positioning wheelchair seat cushion and ensure that it meets the specific requirements outlined in the code description. The documentation should include details such as the width of the wheelchair seat, the specific type and model of the seat cushion used, and any additional information that supports the medical necessity of this enteral support for the patient.

6. Historical Information and Code Maintenance

HCPCS code E2605 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. It is important for medical coders to stay updated on any changes or revisions to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

HCPCS code E2605 is covered by Medicare and other insurance providers. The pricing indicator code 57 indicates that this code is priced by other carriers using their own methodology, rather than being priced under a single methodology. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology. It is important for healthcare providers to understand the specific pricing and coverage guidelines of Medicare and other insurance providers to ensure proper reimbursement for the provision of the positioning wheelchair seat cushion.

8. Examples

Here are five examples of when HCPCS code E2605 should be billed:

  1. A patient with a wheelchair width of 20 inches requires a positioning wheelchair seat cushion for improved comfort and support.
  2. A wheelchair user with limited mobility and pressure ulcer risk needs a specialized seat cushion to prevent skin breakdown.
  3. A pediatric patient with a narrow wheelchair requires a customized seat cushion to accommodate their specific needs.
  4. An elderly patient with a wheelchair width of 18 inches requires a positioning wheelchair seat cushion to alleviate discomfort and promote proper posture.
  5. A patient with a spinal cord injury requires a wheelchair seat cushion with pressure relief features to prevent the development of pressure ulcers.

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