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DME MACS Warn Against Improper E2399 Usage

July 30, 2009 by Laurie Watanabe

NHIC Corp., the Jurisdiction A DME MAC, and CIGNA Government Services, the Jurisdiction C DME MAC, have said they’re receiving claims that improperly use HCPCS code E2399, described as “an interface for a power wheelchair drive control system that is not described by any other HCPCS code.”

Identical notices sent out by NHIC and CIGNA say that for a power wheelchair being initially delivered, usage of the E2399 code should be rare, such as in the cases of “very uncommon types of drive control mechanisms – e.g., a fiber optic switch array.”

Instead, E2399 is being frequently misused on claims to represent “various joystick ‘upgrades,’ including but not limited to the Pride Mobility Products Q-Logic Drive Control System or the Permobil R-net Remote Joystick. This is incorrect coding.”

The notice added that E2399 and K0108 – the code for “wheelchair component or accessory, not otherwise specified” – “must never be used for a component or feature of a joystick at the time of initial issue of a wheelchair.”

Payment for standard proportional remote joysticks with non-expandable controllers is included within the power chair base’s allowable, the statement said. Joysticks with expandable controllers that are provided at the time of the power chair’s initial issue are billed using two other codes:

E2313: Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each.

E2377: Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue.

The statement explained, “The reimbursement for these two codes includes payment for any additional ‘upgrade’ component or feature of a proportional or nonproportional joystick.”

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