Summary & Overview
HCPCS E0117: Articulating, Spring-Assisted Underarm Crutch
HCPCS Level II code E0117 designates an articulating, spring-assisted underarm crutch provided per device. This durable medical equipment code is nationally relevant because underarm crutches remain a common mobility aid prescribed for a range of musculoskeletal and neurologic conditions. Proper coding affects claims processing, supplier reimbursement, and patient access to appropriate assistive devices. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what E0117 represents, typical settings where the device is supplied, and how the code fits into durable medical equipment billing. The publication outlines benchmarks and payer coverage patterns, notes policy or coding updates when applicable, and provides clinical context to explain when an articulating, spring-assisted underarm crutch may be selected over other mobility aids. The content is intended to inform billing staff, DME suppliers, clinicians, and policy analysts about coding implications and common administrative considerations linked to E0117. Data not available in the input will be explicitly identified in relevant sections.
Billing Code Overview
HCPCS Level II code E0117 describes an articulating, spring-assisted underarm crutch, billed per device. Service type: Durable medical equipment (DME) — mobility/assistive device. Typical site of service: Outpatient settings, home health, medical equipment suppliers, and patient residence.
This code covers provision of a single underarm crutch designed with articulating and spring-assisted features to improve gait and reduce user effort. It applies when the device is furnished to assist ambulation for patients who require upper-limb support due to injury, surgery, neurologic or musculoskeletal conditions. If additional components, fittings, or delivery services are provided, separate billing and documentation considerations may apply.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to an orthopedics clinic after a fall at home resulting in a nondisplaced femoral neck fracture treated nonoperatively and limited weight bearing. The patient demonstrates adequate upper-extremity strength but requires mobility assistance to ambulate safely at home and during rehabilitation. After assessment by the orthopedic surgeon and a physical therapist, an underarm articulating, spring-assisted crutch is selected for improved energy efficiency, shock absorption, and joint protection during gait training. The clinic documents medical necessity, trains the patient on proper fitting and use, and arranges durable medical equipment (DME) delivery. Typical workflow: clinician documents diagnosis and weight-bearing status, orders DME using billing code E0117, selects appropriate modifiers if required, obtains prior authorization from the patient’s payor (for example, Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, BUCA, Medicare), coordinates physical therapy gait training, and completes follow-up to assess fit and function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When documentation supports substantially greater work or complexity for fitting, customizing, or modifying the crutch beyond standard practice. |