How To Use HCPCS Code E2616

HCPCS code E2616 describes the positioning wheelchair back cushion, specifically the posterior-lateral type, with a width of 22 inches or greater. This code includes any height and the necessary mounting hardware. In this article, we will explore the details of HCPCS code E2616, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS E2616?

HCPCS code E2616 is used to identify the positioning wheelchair back cushion, posterior-lateral type, with a width of 22 inches or greater. This code is specifically for the cushion and includes any necessary mounting hardware. It is important to note that this code is not applicable for other types of wheelchair cushions or for cushions with a width less than 22 inches.

2. Official Description

The official description of HCPCS code E2616 is “Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. Ensure that the wheelchair back cushion being used is of the posterior-lateral type.
2. Measure the width of the cushion to ensure it is 22 inches or greater.
3. Install the cushion onto the wheelchair, ensuring it is securely mounted.
4. Adjust the height of the cushion as needed to provide proper positioning and support for the wheelchair user.
5. Verify that any necessary mounting hardware is included and properly installed.

4. When to use HCPCS code E2616

HCPCS code E2616 should be used when providing a positioning wheelchair back cushion of the posterior-lateral type with a width of 22 inches or greater. This code is applicable for any height and includes any necessary mounting hardware. It is important to accurately document the specific details of the cushion provided to ensure proper coding and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2616, healthcare providers should ensure that the following documentation is included:

• Documentation confirming the use of a positioning wheelchair back cushion
• Measurement of the cushion width to verify it is 22 inches or greater
• Documentation of any necessary adjustments made to the cushion height
• Verification of the inclusion and installation of any required mounting hardware

Providers should also follow the appropriate billing guidelines and submit the necessary claim forms with the correct coding information.

6. Historical Information and Code Maintenance

HCPCS code E2616 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 is still in use and has not been terminated or replaced.

7. Medicare and Insurance Coverage

HCPCS code E2616 is covered 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 it is not applicable as HCPCS priced under one methodology. Providers should consult the Medicare Carriers Manual Reference Section Number 2130 for further guidance on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code E2616 should be billed:

1. A patient requires a positioning wheelchair back cushion with a width of 24 inches and a posterior-lateral design. The cushion is installed with the necessary mounting hardware.
2. A wheelchair user needs a new back cushion, and their healthcare provider determines that a posterior-lateral cushion with a width of 22 inches is appropriate. The cushion is properly mounted on the wheelchair.
3. A patient’s wheelchair is in need of a replacement back cushion. The healthcare provider selects a posterior-lateral cushion with a width of 26 inches and installs it with the necessary mounting hardware.
4. An individual with specific positioning needs requires a wheelchair back cushion with a width of 28 inches and a posterior-lateral design. The cushion is securely mounted on the wheelchair.
5. A wheelchair user’s current back cushion is worn out and needs to be replaced. The healthcare provider selects a posterior-lateral cushion with a width of 22 inches and installs it with the necessary mounting hardware.