RETIRED - Correct Coding - Center Mount Elevating Leg Rest - Revised - JD DME
RETIRED - Correct Coding - Center Mount Elevating Leg Rest - Revised
Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.
DME MAC Joint Publication
Originally Posted on June 22, 2017
Revised August 10, 2017
This article is revised to correct an error in the billing information for codes E1012 and K0040.
HCPCS code E1012 (WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH) describes a center mount leg rest system that comprises all components of the leg rest, including fixed angle footplates and foot platforms.
Adjustable angle footplates coded K0040 (ADJUSTABLE ANGLE FOOTPLATE, EACH) are separately payable when provided initially with leg rests coded as E1012. The original article published June 22, 2017 incorrectly stated code K0040 could not be billed separately.
Note that reimbursement for code E1012 does include fixed angle footplates and foot platforms. The Wheelchair Options and Accessories LCD-related Policy Article Coding Guidelines state:
There is no separate billing/payment if fixed, swingaway, or detachable footrests or a foot platform without angle adjustment are provided. There is no separate billing for angle adjustable footplates with Group 1 or 2 PWCs. Angle adjustable footplates may be billed separately with Group 3, 4 and 5 PWCs.
Medicare claims for K0108 (WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED) for fixed angle foot platforms or footplates billed in conjunction with code E1012 will be denied as unbundling.
Refer to the Power Mobility Devices and the Wheelchair Options and Accessories LCDs and related Policy Articles for additional information about coverage, coding, and documentation.
For questions about correct coding, contact the Pricing, Data Analysis, and Coding (PDAC) contractor at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form at https://www.dmepdac.com/.
Publication Date: August 10, 2017
- Revised: Corrects an error in the billing information for codes E1012 and K0040
Last Updated Thu, 10 Jan 2019 13:00:09 +0000