E0113 Crutch Underarm — HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II E0113: Crutch Underarm, Wood, with Pad, Tip and Handgrip

HCPCS Level II code E0113 designates a wooden underarm crutch (adjustable or fixed) supplied with pad, tip and handgrip. As a common durable medical equipment (DME) item, this code matters nationally because it reflects routine ambulatory support needs across post-operative care, injury recovery, and rehabilitation pathways. Accurate coding for E0113 affects claims processing, patient access to mobility aids, and DME inventory management.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose and typical sites of service, plus practical billing context: common modifiers, payer coverage patterns, and coding-related considerations affecting reimbursement and documentation. The publication summarizes benchmark metrics where available, highlights emerging policy updates that influence DME authorization and reimbursement, and places the device in clinical context for care teams and billing professionals.

This report is designed for national stakeholders seeking a clear reference on E0113, including coding staff, DME suppliers, clinicians, and payers. Data not available in the input are identified where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE0113HCPCS Level IIdurable medical equipmentcrutchambulatory assistmobility devicerehabilitationDME billingmedical equipment coding

Billing Code Overview

HCPCS Level II code E0113 describes a crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip. This item is a durable medical equipment device intended to provide weight-bearing support and gait assistance for patients with lower-extremity injuries, post-operative mobility limitations, or balance impairment.

Service type: Durable medical equipment (DME) for ambulation support
Typical site of service: Outpatient settings, durable medical equipment suppliers, rehabilitation clinics, home use

Clinical & Coding Specifications

Clinical Context

A patient presents to an outpatient orthopedics clinic after a lower-extremity injury that limits weight-bearing. The clinician evaluates the patient, documents weight-bearing status and need for ambulation assistance, and prescribes a pair of underarm (axillary) crutches. An order for durable medical equipment (DME) is generated specifying E0113 — crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip. The DME supplier verifies the order, confirms patient measurements and fit, delivers the crutches, and provides brief instruction on safe use, transfer techniques, and fall precautions. Typical sites of service include outpatient clinics, hospital discharge planning for home DME, physical therapy clinics, and orthotics/prosthetics suppliers. Documentation in the medical record includes the diagnosis supporting medical necessity, progress notes describing ambulation limitation, the physician or qualified practitioner’s order with quantity and specifications, and the DME supplier’s delivery and education note.

Coding Specifications

Modifier	Description	When to Use
`00`	Standard – no modifier	Use when no modifier applies; billing as usual.
`52`

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HCPCS-E0786-IMPLANTABLE-PROGRAMMABLE-INFUSION-PUMP-REPLACEMENT

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HCPCS-E2387-POWER-WHEELCHAIR-FOAM-FILLED-CASTER-TIRE-REPLACEMENT

HCPCS Level II E2387: Power Wheelchair Foam-Filled Caster Tire, Replacement Only

HCPCS-E0248-HEAVY-DUTY-TRANSFER-BENCH-TUB-TOILET-COMMODE-OPENING

HCPCS Level II E0248: Heavy-Duty Transfer Bench for Tub or Toilet

HCPCS-E0242-BATH-TUB-RAIL-FLOOR-BASE

HCPCS Level II E0242: Bath Tub Rail, Floor Base

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

HCPCS E0781: Ambulatory Infusion Pump, Patient-Worn

HCPCS-E0266-TOTAL-ELECTRIC-HOSPITAL-BED

HCPCS E0266: Total Electric Hospital Bed (Head, Foot, Height Adjustments)

HCPCS-E0675-PNEUMATIC-COMPRESSION-DEVICE-ARTERIAL-INSUFFICIENCY

HCPCS E0675: Pneumatic Compression Device for Arterial Insufficiency

HCPCS-E1014-PEDIATRIC-WHEELCHAIR-RECLINING-BACK

HCPCS Level II E1014: Reclining Back Addition to Pediatric Wheelchair

HCPCS-E2340-POWER-WHEELCHAIR-NONSTANDARD-SEAT-WIDTH-20-23-INCH

HCPCS E2340: Power Wheelchair Nonstandard Seat Frame Width 20-23 inches

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Taxonomy Code	Specialty	Notes
`208000000X`	Physical Medicine & Rehabilitation	Clinicians who assess mobility needs and prescribe ambulatory DME.
`208VP0000X`	Physical Therapist	Performs gait assessment, fitting and training for crutch use.
`207Q00000X`	Orthopedic Surgery	Orders DME for post-operative or injury-related limited weight-bearing.
`261QM0800X`	Prosthetics & Orthotics	Supplier specialty for device provision and modifications.
`362LA2200X`	Durable Medical Equipment Supplier	DME suppliers responsible for delivery, fitting, and billing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S82.201A`	Unspecified fracture of lower leg, right leg, initial encounter for closed fracture	Acute tibia/fibula injury requiring nonweight-bearing and crutch use.
`S82.101A`	Unspecified fracture of lower leg, left leg, initial encounter for closed fracture	Left lower-extremity fracture necessitating ambulation aid.
`S72.001A`	Fracture of femur, unspecified part, right, initial encounter for closed fracture	Proximal lower-extremity fracture often requires crutches post-injury or surgery.
`M25.561`	Pain in right knee	Knee pain limiting ambulation where crutches provide offloading.
`M54.16`	Radiculopathy, lumbar region	Lumbar radiculopathy producing lower-extremity weakness altering gait and requiring crutches.
`R26.2`	Difficulty in walking, not elsewhere classified	General gait disturbance where underarm crutches are indicated for safe ambulation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97161`	Physical therapy evaluation, low complexity	Evaluation that may precede ordering `E0113` to document mobility deficits and need for crutches.
`97110`	Therapeutic exercises	Therapy services that accompany crutch training for strength and endurance.
`97530`	Therapeutic activities	Functional mobility training often performed when teaching crutch use and transfers.
`99213`	Office/outpatient visit, established patient, low complexity	Office visit where the clinician documents diagnosis, justifies medical necessity, and places the DME order for `E0113`.
`99456`	Work-related or medical-legal evaluation services	Used when a formal functional capacity evaluation supports a medical necessity decision tied to crutch provision.

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