How To Use HCPCS Code E2631

HCPCS code E2631 describes a wheelchair accessory that is an addition to a mobile arm support, specifically designed to elevate the proximal arm. This code is used to identify and bill for this specific wheelchair accessory, and it is important for medical coders to understand its meaning, usage, and billing guidelines. In this article, we will delve into the details of HCPCS code E2631, providing a comprehensive understanding of its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples of when this code should be billed.

1. What is HCPCS E2631?

HCPCS code E2631 is a specific code used to identify a wheelchair accessory that is an addition to a mobile arm support. This accessory is designed to elevate the proximal arm, providing additional support and comfort for wheelchair users. It is important to note that this code is specific to this particular accessory and should not be used for any other wheelchair accessories or supplies.

2. Official Description

The official description of HCPCS code E2631 is “Wheelchair accessory, addition to mobile arm support, elevating proximal arm.” This description accurately represents the purpose and function of the wheelchair accessory. The short description for this code is “Parenteral supp not othrws c,” which further clarifies that it is a parenteral supply and not classified under any other category.

3. Procedure

1. The procedure for utilizing the wheelchair accessory described by HCPCS code E2631 involves attaching it to a mobile arm support that is already installed on the wheelchair.
2. Ensure that the accessory is securely fastened to the mobile arm support, following the manufacturer’s instructions.
3. Adjust the accessory to the desired height to elevate the proximal arm of the wheelchair user.
4. Verify that the accessory is providing the necessary support and comfort to the user’s arm.
5. Make any necessary adjustments or modifications to ensure proper fit and functionality.

4. When to use HCPCS code E2631

HCPCS code E2631 should be used when a healthcare provider or supplier is providing the specific wheelchair accessory described by this code. It is important to ensure that the accessory being used matches the description and purpose outlined in the official description. This code should not be used for any other wheelchair accessories or supplies.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2631, healthcare providers need to document the medical necessity for the wheelchair accessory and include this documentation in the patient’s medical record. The documentation should clearly state the need for the accessory, the specific condition or disability it addresses, and any other relevant information supporting its use.

When submitting the claim, the provider should include the appropriate HCPCS code (E2631) along with any other relevant codes for the wheelchair and other services provided. It is important to follow the specific billing guidelines and requirements of the payer, such as Medicare or private insurance companies, to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E2631 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, 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 inclusion in the coding system.

7. Medicare and Insurance Coverage

HCPCS code E2631 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 it is not applicable as HCPCS priced under one methodology.

It is important for healthcare providers to verify the coverage and reimbursement policies of each individual payer to ensure proper billing and reimbursement for the wheelchair accessory described by HCPCS code E2631.

8. Examples

Here are five examples of when HCPCS code E2631 should be billed:

1. A patient with limited arm mobility requires the wheelchair accessory to elevate their proximal arm for improved comfort and support.
2. A wheelchair user with a specific medical condition that affects their arm function needs the accessory to assist with arm elevation.
3. A healthcare provider prescribes the wheelchair accessory as part of the patient’s treatment plan for a specific arm-related condition.
4. A physical therapist recommends the accessory to a wheelchair user during a rehabilitation program to aid in arm mobility and strength.
5. A wheelchair user experiences discomfort and pain in their proximal arm and requires the accessory to alleviate these symptoms.