Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

E1170 - E1200  Wheelchair - Amputee

E1170
Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests
shortWhlchr ampu fxd arm leg rest
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1171
Amputee wheelchair, fixed full length arms, without footrests or legrest
shortWheelchair amputee w/o leg r
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1172
Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest
shortWheelchair amputee detach ar
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1180
Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests
shortWheelchair amputee w/ foot r
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1190
Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests
shortWheelchair amputee w/ leg re
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1195
Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests
shortWheelchair amputee heavy dut
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1200
Amputee wheelchair, fixed full length arms, swing away detachable footrest
shortWheelchair amputee fixed arm
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment