Question 1

What is HCPCS code E1220?

Accepted Answer

HCPCS code E1220 is "Whlchr special size/constrc". Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification

Question 2

What category is E1220 in?

Accepted Answer

E1220 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E1220?

Accepted Answer

Use E1220 when billing for whlchr special size/constrc. 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 E1220 covered by Medicare?

Accepted Answer

Coverage for E1220 (Whlchr special size/constrc) 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 E1220?

Accepted Answer

Documentation for E1220 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).