| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
E0954 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot |
| HCPCS Short Description |
Foot box, any type each foot |
| HCPCS Pricing Indicator Code 1 |
32 - Inexpensive & routinely purchased DME (price subject to floors and ceilings) |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
D1D - Wheelchairs |
| HCPCS Type Of Service Code 1 |
A - Used durable medical equipment (DME) |
| HCPCS Type Of Service Code 2 |
P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Type Of Service Code 3 |
R - Rental of DME |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2018 |
| HCPCS Action Effective Date |
1/1/2018 |
| HCPCS Action Code |
A - Add procedure or modifier code |