Question 1

What is HCPCS code E0638?

Accepted Answer

HCPCS code E0638 is "Standing frame sys". Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels

Question 2

What category is E0638 in?

Accepted Answer

E0638 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0638?

Accepted Answer

Use E0638 when billing for standing frame sys. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is E0638 covered by Medicare?

Accepted Answer

Coverage for E0638 (Standing frame sys) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for E0638?

Accepted Answer

Documentation for E0638 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).