E1220 HCPCS - WHEELCHAIR; SPECIALLY SIZED OR CONSTRUCTED, (INDICATE BRAND NAME, MODEL NUMBER, IF ANY) AND JUSTIFICATION

Code Information

HCPCS Code: E1220
Sequence Number: 0010
Short Description: Whlchr special size/constrc
Long Description: Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
Date Added: 1/1/1986
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/1990
Classification: Durable Medical Equipment
Coding System: HCPCS

Pricing Indicator Code:
- 45 - Customized DME items
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
- 60-6
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: D - Special coverage instructions apply

Field Name	Field Value
Healthcare Common Procedure Coding System Code	E1220
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; specially sized or constructed, (indicate brand name, model number, if any) and justification
HCPCS Short Description	Whlchr special size/constrc
HCPCS Pricing Indicator Code 1	45 - Customized DME items
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number 1	60-6
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Berenson-Eggers Type Of Service Code	D1D - Wheelchairs
HCPCS Type Of Service Code 1	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/1986
HCPCS Action Effective Date	1/1/1990
HCPCS Action Code	N - No maintenance for this code