How To Use HCPCS Code E8001

HCPCS code E8001 describes a gait trainer specifically designed for pediatric patients who require upright support. This code includes all the necessary accessories and components for the gait trainer. In this article, we will explore the details of HCPCS code E8001, 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 E8001?

HCPCS code E8001 is used to identify a gait trainer that is specifically designed for pediatric patients who require upright support. This code includes all the necessary accessories and components for the gait trainer. It is important to note that this code is specifically for pediatric-sized gait trainers and should not be used for adult-sized or other types of gait trainers.

2. Official Description

The official description of HCPCS code E8001 is “Gait trainer, pediatric size, upright support, includes all accessories and components.” The short description for this code is “Enteral supp not otherwise c.” This description accurately reflects the purpose and components included in this specific gait trainer.

3. Procedure

1. Position the pediatric patient in the gait trainer, ensuring proper fit and alignment.
2. Attach any additional accessories or components as needed, such as handrails or footplates.
3. Provide instructions and guidance to the patient on how to use the gait trainer effectively and safely.
4. Monitor the patient’s progress and make any necessary adjustments to the gait trainer as needed.

4. When to use HCPCS code E8001

HCPCS code E8001 should be used when providing a gait trainer specifically designed for pediatric patients who require upright support. This code is applicable when the gait trainer includes all the necessary accessories and components. It is important to ensure that the patient meets the criteria for using a pediatric-sized gait trainer and requires the additional support provided by the upright design.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E8001, healthcare providers should ensure that the following documentation is included:

• Medical records indicating the need for a pediatric-sized gait trainer with upright support.
• Documentation supporting the medical necessity of the gait trainer for the specific patient.
• Itemized list of all accessories and components included with the gait trainer.
• Any additional documentation required by the payer or insurance company.

6. Historical Information and Code Maintenance

HCPCS code E8001 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 E8001 is covered by Medicare. 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 to verify coverage and reimbursement policies with individual insurance companies to determine if they provide coverage for gait trainers with upright support for pediatric patients.

8. Examples

Here are five examples of when HCPCS code E8001 should be billed:

1. A 5-year-old child with cerebral palsy requires a gait trainer with upright support to improve their mobility and independence.
2. A 3-year-old child with spina bifida needs a pediatric-sized gait trainer with all the necessary accessories and components to assist with their walking abilities.
3. A 7-year-old child with developmental delays requires a gait trainer with upright support to help them learn to walk and improve their balance.
4. A 4-year-old child with muscular dystrophy needs a specialized gait trainer with additional support to assist with their mobility and prevent falls.
5. A 6-year-old child with a lower limb amputation requires a gait trainer with upright support and customized accessories to help them adapt to their new prosthetic limb.