Summary & Overview
HCPCS E0105: Cane, Quad or Three Prong, Adjustable or Fixed
HCPCS Level II code E0105 designates a quad- or three-prong cane, adjustable or fixed, with tips. As a common durable medical equipment item, this cane supports ambulatory function for patients with balance, strength, or stability limitations. Nationally, coverage and utilization of basic mobility aids like E0105 affect access to assistive devices, outpatient supplier workflows, and durable medical equipment program costs.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical context, typical sites of service, and the payer landscape. The publication summarizes coverage considerations, common billing practices, and relevant benchmarks where available.
The report provides practical reference material: a clear definition of the code and device, common settings where the cane is supplied and used, payer coverage patterns, and notes on common modifiers and billing elements. Data gaps are identified where input information is incomplete. This summary serves clinicians, DME suppliers, and billing professionals seeking a national-level briefing on HCPCS Level II code E0105.
Billing Code Overview
HCPCS Level II code E0105 describes a cane, quad or three prong, including canes of all materials, adjustable or fixed, with tips. This item represents a durable medical equipment device intended to provide ambulation support for patients with balance or mobility impairments.
Service Type: Durable Medical Equipment (DME), mobility aid
Typical Site of Service: Outpatient settings, durable medical equipment suppliers, home use
Clinical & Coding Specifications
Clinical Context
A 78-year-old ambulatory patient with chronic peripheral neuropathy and balance impairment presents to an outpatient durable medical equipment (DME) clinic after a physician’s evaluation. The clinician documents recurrent falls and recommends a mobility aid. A DME supplier evaluates gait, home environment, and patient strength, and selects a quad cane (E0105) to improve stability. The supplier documents medical necessity, measurement and fitting, provides instruction on proper cane height and use, and delivers the product. Typical site of service is outpatient DME supplier locations, physician offices, hospital outpatient clinics, skilled nursing facilities, or the patient’s home when delivery is required. The clinical workflow includes physician order with diagnosis, DME supplier assessment, prior authorization if required by payer (for example Medicare or commercial payors), delivery and patient education, and documentation of dispensing and beneficiary signature for billing with E0105.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | When a furnished cane is limited in scope from what was ordered or typically provided |