The Goodbye Crutches Blog

What is the HCPC Code for a Roll-about Knee Walker?

Posted by Tom Schwab

Roll-aboutHCPCS E0118: 

Crutch substitute, lower leg platform, with or with out wheels, each.

This generic code is applicable for all Knee Scooter regardless of brand  (Roller-aid, Free Spirit, Kneal Knee Cruiser, Roll-about (r) , Turning Leg Caddy, Roller Foot, Drive Nee Bop, Weil, etc.)

 

So What is a HCPCS Code?

HCPCS Codes, often pronounce “Hics Pics” is the Healthcare Common Procedure Coding System.  It is a system of numbers and codes used by Medicare and monitored by CMS, the Centers for Medicare and Medicaid Services. Most all private insurance companies use this same coding system

Your doctor uses Level I HCPCS Codes for procedures or services.  For example 99214 may be used for a physical. Check any recent bill and you will see everything billed has an associated HCPCs Code

Regardless if you purchase or rent a Knee Walker it is a Level II HCPCS codes that are used by medical suppliers other than physicians, such as ambulance services or durable medical equipment. These are typically not costs that get passed through a physician's office so they must be dealt with by Medicare or Medicaid differently from the way a health insurance company would deal with them.

You may also need to provide your CPT Code?

In addition to the HCPC code your insurance company will most likely ask for your CPT Code.  The Current Procedural Technology codes developed by the American Medical Association tells them what procedure was performed.  For example 77.56 is the surgical repair of a hammer toe.

Why do I need a CPT and a HCPS Code?

To determine benefits your insurance provider will look at both what the device is (A Knee Scooter) and what procedure made it a necessity (A Bunionectomy).  If either of the codes is incorrect it could cause an automatic denial.  For example, if Knee Scooters are covered benefit they wouldn’t be for a Rhinoplasty (nose job).

Why MUST I get CPT code from the doctor’s office?

While it may be possible for you to Google the CPT code, always obtain it from your doctor’s office directly.  It is a common question, and a request that they should easily be able to obtain form your chart or bill.  Often there are qualifiers they may use.  If you submit a CPT code different from your doctor both your claim for your knee scooter along with the physician’s claim and the hospital / surgery center claim could be delayed.

 

Learn more about Knee Walkers including tips for getting your insurance provider to cover it,

Get the Free Knee Walker's Buyer's Guide

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Topics: FAQ, insurance, Knee Walker

    

 

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