Question 1

What is HCPCS code E0738?

Accepted Answer

HCPCS code E0738 is "Upper extremity rehab". Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories

Question 2

What category is E0738 in?

Accepted Answer

E0738 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0738?

Accepted Answer

Use E0738 when billing for upper extremity rehab. 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 E0738 covered by Medicare?

Accepted Answer

Coverage for E0738 (Upper extremity rehab) 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 E0738?

Accepted Answer

Documentation for E0738 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).