Understanding HCPCS Code E2298 and Related Billing Guidelines

The E2298 (complex rehabilitative power wheelchair accessory, power seat elevation system, any type) is covered if a beneficiary meets the coverage criteria for either a Group 2 single power option or multiple power option power-driven wheelchair, or a Group 3 power-driven wheelchair as described in the Power Mobility Devices LCD as codes K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, and K0864 and meets the coverage criteria for seat elevation equipment as described in CMS Medicare National Coverage Determinations (NCD) Manual (Pub. 100-03) Chapter 1, Part 4, Section 280.16 Seat Elevation Equipment (Power Operated) on Power Wheelchairs. Below is a detailed breakdown of its usage and associated guidelines:

Billing Rental or Purchase Options with Correct Modifiers

The beneficiary has the option to purchase or rent the base chair. The E2298 will be billed based on the option chosen by the beneficiary for the base chair of either rental or purchase.

  • Rental Option: Use modifiers RRBRKX for both the base chair and accessory (e.g., E2298RRBRKX).
  • Purchase Option: Use modifiers NUBPKX for both the base chair and accessory (e.g., E2298NUBPKX).

Noncomplex Rehabilitative Power Wheelchairs: K0830 and K0831

  • Usage: Codes K0830 and K0831 are designated for noncomplex rehabilitative power wheelchairs equipped with seat elevation systems. These codes must be officially verified by the PDAC (Pricing, Data Analysis, and Coding) to ensure compliance with Medicare billing requirements.
  • When providing a heavy duty or very heavy-duty power wheelchair described by HCPCS codes K0824, K0825, K0826, K0827, K0828, and K0829, that could include a seat elevation system, that system, if included, would be billed separately under HCPCS code K0108 by using HCPCS codes K0824 - K0829 plus K0108 (see below).

Miscellaneous Code K0108

  • Purpose: Use code K0108 for wheelchair components or accessories not otherwise specified. It is applicable for retrofitting power seat elevation equipment onto noncomplex rehabilitative power wheelchairs owned by beneficiaries.
  • Billing Requirements: When using K0108, suppliers must include detailed information in the narrative field:
    • Description of the item or service
    • Manufacturer name
    • Product name, model name, and number
    • Supplier Price List (PL) amount
    • HCPCS code of related item (if applicable)
    • If repair part is repaired, the HCPCS code of item being repaired
  • Group 2 and Group 5 Bases: K0108 can also be applied to Group 2 noncomplex heavy-duty bases (K0824, K0825, K0826, K0827, K0828, and K0829) and Group 5 power driven wheelchair bases. For instance, a K0825 wheelchair with an accessory seat elevation system can be billed using K0108.

Note: The K0108 is not included in the voluntary prior authorization review for power mobility accessories.

Resources

Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )