E0112 Underarm Wooden Crutches HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

HCPCS Level II code E0112 denotes a pair of wooden underarm (axillary) crutches, adjustable or fixed, supplied with pads, tips, and handgrips. As a common durable medical equipment (DME) item, this code is used to bill for basic mobility assistance devices that support ambulation following injury, surgery, or for chronic mobility limitations. Nationally, standardized coding for crutches helps ensure consistent coverage determinations, supplier billing, and claims processing across commercial payers and Medicare.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, explanations of billing relevance for suppliers and discharge planners, and a summary of what to expect in payer coverage policies and claims processing for basic underarm crutches. The publication highlights common billing considerations, typical documentation elements required by payers, and where to look for policy guidance. Data not available in the input for specific payer policy details, reimbursement rates, or associated ICD‑10 codes is noted as unavailable. The aim is to provide a clear, national‑level reference for clinicians, DME suppliers, and billing professionals handling claims involving HCPCS Level II code E0112.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareE0112HCPCS Level IIdurable medical equipmentmobility aidscrutchesunderarm crutchesbillingDME coding

Billing Code Overview

HCPCS Level II code E0112 describes underarm (axillary) crutches made of wood, adjustable or fixed, sold as a pair and supplied with pads, tips, and handgrips. This item is a durable medical equipment supply used to assist ambulation for patients with temporary or chronic lower‑extremity impairments.

Service Type: Durable Medical Equipment (DME) — mobility aid

Typical Site of Service: Retail medical equipment suppliers, outpatient durable medical equipment providers, inpatient discharge supply arrangements, and home delivery settings

Clinical & Coding Specifications

Clinical Context

A patient presents to an outpatient durable medical equipment (DME) supplier or an orthopedics clinic after sustaining a lower-extremity injury that requires temporary offloading of weight and improved mobility. Typical patients include adults or elderly individuals with ankle sprains, tibial or fibular fractures managed non-operatively, postoperative knee arthroscopy recovering for partial weight bearing, or chronic conditions such as severe osteoarthritis with instability where short-term crutch use is prescribed. The clinical workflow: a clinician (orthopedic surgeon, primary care physician, or physical therapist) documents the medical necessity and prescribes ambulatory support. The patient is measured for E0112 (crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips). The DME supplier verifies coverage and eligibility with the payor, obtains any required prior authorization or documentation (including diagnosis, duration, and mobility limitations), dispenses the equipment, provides basic instruction on fit and safe use, and documents delivery and patient education in the medical record. Follow-up typically occurs in 1–6 weeks to reassess mobility needs and determine ongoing DME requirements or transition to other assistive devices.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier applicable (placeholder)	Rarely used; not typically appended to DME HCPCS lines but may appear in payer systems as a default.

HCPCS E1803: Dynamic Adjustable Elbow Extension Device, With Soft Interface

HCPCS-E0912-HEAVY-DUTY-TRAPEZE-BAR-FREE-STANDING

HCPCS E0912: Heavy-Duty Free-Standing Trapeze Bar, >250 lb capacity

HCPCS-E0955-WHEELCHAIR-HEADREST-CUSHIONED

HCPCS E0955: Wheelchair Cushioned Headrest, Including Mounting Hardware

HCPCS-E1812-DYNAMIC-KNEE-EXTENSION-FLEXION-DEVICE-ACTIVE-RESISTANCE

HCPCS E1812: Dynamic Knee Extension/Flexion Device with Active Resistance Control

HCPCS-E0292-HOSPITAL-BED-VARIABLE-HEIGHT-HI-LO-WITHOUT-SIDE-RAILS-WITH-MATTRESS

HCPCS E0292: Hospital Bed, Variable Height Hi‑Lo Without Side Rails

HCPCS-E2215-WHEELCHAIR-CASTER-TUBE

HCPCS E2215: Manual Wheelchair Caster Tube, Pneumatic

HCPCS-E0463-PRESSURE-SUPPORT-VENTILATOR-VOLUME-CONTROL-TRACHEOSTOMY

HCPCS E0463: Pressure Support Ventilator with Volume Control Mode

HCPCS-E0781-AMBULATORY-INFUSION-PUMP-PATIENT-WORN

HCPCS E0781: Ambulatory Infusion Pump, Patient-Worn

HCPCS-E0165-COMMODE-CHAIR-MOBILE-STATIONARY-DETACHABLE-ARMS

HCPCS E0165: Commode Chair, Mobile or Stationary, Detachable Arms

HCPCS-E1227-SPECIAL-HEIGHT-ARMS-WHEELCHAIR

HCPCS Level II E1227: Special Height Arms for Wheelchair

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Taxonomy Code	Specialty	Notes
`208000000X`	Orthopedic Surgery	Common prescribers for crutches after fractures, joint procedures, or soft-tissue injuries.
`207Q00000X`	Physical Medicine & Rehabilitation	Prescribes and coordinates mobility aids during recovery and rehab.
`261QM0800X`	Physical Therapist	Performs fitting, patient education, and functional assessment for crutch use.
`207R00000X`	Family Medicine	Primary care clinicians who prescribe DME for acute injuries or chronic mobility limitations.
`2086S0123X`	Sports Medicine (subspecialty)	Prescribes crutches for athletic injuries and postoperative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S82.201A`	Unspecified fracture of shaft of right tibia, initial encounter for closed fracture	Tibial shaft fractures commonly require weight-bearing restrictions and crutch use.
`S82.202A`	Unspecified fracture of shaft of left tibia, initial encounter for closed fracture	Left-sided tibial fractures with non-weight-bearing or partial weight-bearing prescriptions.
`S93.401A`	Sprain of unspecified ligament of right ankle, initial encounter	Ankle sprains often require temporary immobilization and crutch-assisted ambulation.
`S93.402A`	Sprain of unspecified ligament of left ankle, initial encounter	Left ankle sprain leading to crutch prescription for offloading.
`M17.11`	Unilateral primary osteoarthritis, right knee	Severe knee osteoarthritis with instability or pain may prompt temporary use of crutches.
`M17.12`	Unilateral primary osteoarthritis, left knee	Left knee osteoarthritis limiting ambulation where crutches are prescribed.
`Z47.1`	Aftercare following joint replacement	Postoperative period after lower extremity joint replacement when crutches are used during rehabilitation.
`S81.001A`	Open wound of right knee, initial encounter	Lower-extremity soft tissue injuries that impair weight bearing and necessitate crutch use.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common outpatient visit during which the clinician documents need for crutches and writes the DME prescription.
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes	Physical therapy session where gait training with crutches is provided after device fitting.
`97001`	Physical therapy evaluation (initial)	Evaluation that documents functional status and justifies the need for ambulatory assistive device like `E0112`.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Occasionally used for minor additional supplies related to device fitting in clinic billing contexts.
`99456`	Work related or medical disability evaluation services (e.g., impairment rating)	Used when an impairment assessment documents functional limitations requiring crutch use for work restrictions.

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