Tag: Coding
DME MACs clarify billing for power wheelchair electronic codes
October 6, 2025HME News Staff
WASHINGTON – The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) address the confusion around billing certain power wheelchair electronic codes in a joint publication on Oct. 2. “This article provides instructions on the appropriate billing of power wheelchair electronics, such as actuators, controllers, harnesses and interfaces. The instructions apply specifically to:
E2310 Power wheelchair accessory, electronic connection between wheelchair controller...
DME MACs change coding for wheelchair accessories
March 17, 2025HME News Staff
WASHINGTON – CMS is revising E1028 and creating three new HCPCS codes for wheelchair accessories effective April 1.
A joint DME MAC publication announced the following updates:
Revise existing HCPCS Level II code E1028, "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory" to instead read "Wheelchair accessory, manual swingaway, retractable or removable mounting...
PDAC preps for new cath codes
January 9, 2025HME News Staff
WASHINGTON – The Pricing, Data Analysis and Coding (PDAC) contractor for CMS seeks primary contact information from manufacturers and distributors as it prepares to roll out new HCPCS codes for hydrophilic intermittent urinary catheters on Jan. 1, 2026, AAHomecare reports.
Manufacturers and distributors can provide their primary contact by completing this form by March 31. Over the course of the year, the PDAC will work with the primary contact to determine if their products qualify...
Noridian responds to orthotics inquiries
September 23, 2024HME News Staff
WASHINGTON – Noridian Healthcare Solutions has published an update for billing custom-fitted orthotics when no custom fitting is completed with no off-the-shelf equivalent available. “Due to recent inquiries from suppliers, it has come to our attention that some miscellaneous codes used for billing off-the-shelf orthotics, when a custom fit orthotic is provided but no custom fitting is performed, may require specific policy and laterality modifiers,” it states. These claims must...
Tactile secures coding for Nimbl
September 17, 2024HME News Staff
MINNEAPOLIS – Tactile Systems has announced that the Pricing, Data Analysis and Coding (PDAC) contractor for CMS has approved the use of HCPCS code E0651 to bill for its Nimbl pneumonia compression platform. The PDAC’s approval follows the company’s 510(k) clearance from the U.S. Food and Drug Administration in June. “The receipt of PDAC approval for Nimbl comes earlier than expected, and we are pleased that CMS recognizes the potential health and quality-of-life enhancing...
CMS proposes coding changes for intermittent urinary catheters
May 6, 2024HME News Staff
WASHINGTON – CMS has proposed discontinuing two existing HCPCS codes for intermittent urinary catheters, A4351 and A4352, and establishing five new codes in response to a request from AAHomecare and its manufacturer members.
The agency stated that it does not see a claims processing need to discontinue or modify existing HCPCS code A4353, “Intermittent urinary catheter, with insertion supplies.”
“CMS believes that clinical evidence and current payer policies...
Stakeholders on seat elevation: ‘We need more details’
March 20, 2024Liz Beaulieu, Editor
WASHINGTON – Complex rehab stakeholders are disappointed in CMS’s payment rate for seat elevation systems and have requested a meeting with the agency to learn more about how it landed on about $2,000.
That rate is lower than the $2,800, on average, that providers are being paid for the systems on an interim basis, and significantly lower than the rate stakeholders had recommended.
“The payment piece was disappointing,” said Wayne Grau, executive director...
CMS releases coding, payment info for seat elevation systems
March 4, 2024HME News Staff
WASHINGTON – CMS has announced coding and payment information for seat elevation systems for complex rehab power wheelchairs, AAHomecare has reported.
The key takeaways, according to the association:
Discontinues existing HCPCS Level II code E2300, “Wheelchair accessory, power seat elevation system, any type,” effective March 31, 2024
Establishes E2298, “Complex rehabilitative power wheelchair accessory, power seat elevation system, any...
CMS releases coding plan for power seat elevation
November 13, 2023HME News Staff
WASHINGTON – CMS has issued preliminary recommendations for coding and pricing for power seat elevation systems, NCART has reported.
The recommendations include discontinuing the existing HCPCS Level II code E2300, “wheelchair accessory, power seat elevation system, any type,” and establishing two new HCPCS Level II codes at a set fee schedule amount:
EXXXX, “complex rehabilitative power wheelchair accessory, power seat elevation system, any type”
EXXXX,...
AdvancedMD releases codebook
March 6, 2023HME News Staff
SOUTH JORDAN, Utah – AdvancedMD, a software provider, has released its 2023 CPT/HCPCS Codebook. The resource includes the full list of updated CPT/HCPCS codes, identifying which medical codes have been added, revised and deleted by CMS. “Billing errors are an expensive mistake, equating to approximately $125 billion in uncollected money each year,” said Tim Constantino, vice president and head of product at AdvancedMD. “Not only do incorrect codes result in massive bill collection...