Article Detail - JD DME

Original Effective Date: 06/04/2010
Revision Effective Date: 11/01/2013

Recently it has come to the attention of the DME MACs that there is confusion regarding the billing of mounting hardware for wheelchair accessories. This article provides instructions on appropriate billing of mounting hardware, Healthcare Common Procedure Coding System (HCPCS) code E1028.

Code E1028 is described as a wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory. The local coverage determination (LCD) for Wheelchair Options and Accessories states: "One example (not all-inclusive) of a covered indication for swingaway, retractable, or removable hardware (E1028) would be to move the component out of the way so that a patient can perform a slide transfer to a chair or bed."

Since this code encompasses various types of hardware, suppliers must add a description for each E1028 billed. For example, if billing an E1028 for a joystick, add the comment "retractable joystick mounting." In addition, the description provided should coincide with a corresponding HCPCS code that requires or can accommodate specialty hardware. For example, if billing an E1028 for swingaway lateral support hardware, the corresponding code for lateral supports should be on the same claim. If the billing order does not allow this, then the corresponding code must be in the billing history for the E1028 to be paid.

Suppliers are reminded that mounting hardware, fixed, is not separately payable.

Suppliers are encouraged to read the entire LCD and policy article for Wheelchair Options and Accessories and Wheelchair Seating for additional coverage, coding and documentation requirements.