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Tuesday, September 29, 2009

Jurisdiction B News: HCPCS Code E1028 Used for Multiple Items -- REVISED

 
 
 
 
HCPCS Code E1028 Used for Multiple Items -- REVISED

The Healthcare Common Procedure Coding System (HCPCS) code E1028 is defined as manual swingaway, retractable, or removable mounting hardware for a joystick, other power wheelchair control interface, or positioning accessory. Fixed mounting hardware is included in the allowance for these codes.  E1028 represents an incremental upcharge when specialty hardware is substituted for fixed hardware.
 This hardware can be used with many components on a power wheelchair.  Multiple items may be billed on the same claim using this code.

When submitting a claim with multiple items that must be coded with HCPCS code E1028, the following instructions must be applied.Each different item (i.e., swingaway hardware for a medial thigh support, swingaway hardware for lateral trunk supports, retractable joystick mount, etc.) billed as an E1028 must be submitted on a separate claim line.
Each E1028 claim line must include a narrative description of the item, including the brand name, make/model, and the part number. 
Suppliers who bill claims electronically should enter the narrative information in the NTE segment of the electronic claim. Suppliers who submit paper claims should indicate the narrative information in Item 19 of the CMS-1500 claim form. Claims submitted without this required information will be denied.

For additional information on the different items that may be billed using HCPCS code E1028, refer to the Coding Guidelines section of the Wheelchair Options and Accessories Policy Article located on the National Government Services Web site at:
http://www.ngsmedicare.com/NGSMedicare/dme_lcd/L27223_active_sia.htm or the Durable Medical Equipment Coding System (DMECS) at: https://www.dmepdac.com/index.html.

 
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