HCPCS Level II E0191: Heel or Elbow Protector, Each

HCPCS Level II code E0191 describes a single heel or elbow protector used to cushion and offload pressure for skin protection; the service is an dressing/supportive device typically supplied for use in inpatient, long-term care, or home health settings to reduce pressure-related injury to heels or elbows.

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HCPCS Level II E0191: Heel or Elbow Protector, Each

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Get alerted when payer policies referencing E0191 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an immobile or bedbound adult in an acute care hospital, long-term care facility, or home health setting who is at risk for or has developing pressure-related skin breakdown over the heels or elbows. The care team includes a physician (hospitalist, geriatrician, or primary care), a wound care nurse or certified wound specialist, and a physical or occupational therapist. The clinician assesses skin integrity, documents risk factors (limited mobility, neuropathy, peripheral vascular disease, malnutrition), and orders pressure-relief devices. A durable medical equipment supplier provides a pair of protective devices when indicated. The device coded as E0191 (heel or elbow protector, each) is applied directly to the affected anatomical site to cushion and redistribute pressure, reduce shear, and protect bony prominences. Common clinical workflow steps: wound/skin assessment, physician order for pressure-relief device, documentation of medical necessity (risk of pressure injury or existing Stage I–II ulcer), DME supplier delivery and fitting, nursing education on use and skin checks, and follow-up skin reassessment during subsequent visits.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97112`	Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation	Performed by therapists to address mobility and positioning that complement use of heel/elbow protectors.
`97530`	Therapeutic activities, direct patient contact, each 15 minutes	Therapy sessions that include training in transfers and repositioning to reduce pressure injury risk.
`99509`	Home visit for prophylactic or therapeutic medication or device provision	Used in home health contexts when clinicians provide and instruct on DME like `E0191`.
`11042`	Debridement, subcutaneous tissue (for wound care)	If a pressure ulcer requires debridement, this CPT may be billed during wound management alongside device provision.
`99304`	Initial nursing facility care, per day	Facility-based evaluation where orders for protective devices such as `E0191` may be placed and documented.

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
74	Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…	- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
251S00000X	Community/Behavioral Health Agency	A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intell…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
2471B0102X	Bone Densitometry Radiologic Technologist	A radiologic technologist who specializes in bone densitometry and is appropriately educated and trained, consistent with nationally recognized standa…
226300000X	Kinesiotherapist	A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designe…

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS Level II E0112: Underarm Wooden Crutches, Pair

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Crutch Substitute, Lower Leg Platform

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97112`	Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation	Performed by therapists to address mobility and positioning that complement use of heel/elbow protectors.
`97530`	Therapeutic activities, direct patient contact, each 15 minutes	Therapy sessions that include training in transfers and repositioning to reduce pressure injury risk.
`99509`	Home visit for prophylactic or therapeutic medication or device provision	Used in home health contexts when clinicians provide and instruct on DME like `E0191`.
`11042`	Debridement, subcutaneous tissue (for wound care)	If a pressure ulcer requires debridement, this CPT may be billed during wound management alongside device provision.
`99304`	Initial nursing facility care, per day	Facility-based evaluation where orders for protective devices such as `E0191` may be placed and documented.

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
74	Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…	- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
251S00000X	Community/Behavioral Health Agency	A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intell…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
2471B0102X	Bone Densitometry Radiologic Technologist	A radiologic technologist who specializes in bone densitometry and is appropriately educated and trained, consistent with nationally recognized standa…
226300000X	Kinesiotherapist	A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designe…

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS Level II E0112: Underarm Wooden Crutches, Pair

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Crutch Substitute, Lower Leg Platform

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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HCPCS Level II E0191: Heel or Elbow Protector, Each

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HCPCS Level II E0191: Heel or Elbow Protector, Each

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS Level II E0191: Heel or Elbow Protector, Each

Sign up for hcpcs E0191 policy alerts

HCPCS Level II E0191: Heel or Elbow Protector, Each

Sign up for hcpcs E0191 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code E0191 represent and where is it commonly used?

Under what clinical circumstances is E0191 typically ordered and what are the typical workflow steps?

Which billing modifiers are referenced for use with E0191?

Which payers are referenced and how is E0191 categorized for reimbursement?

What related CPT codes are listed and how do they relate to billing for E0191?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code E0191 represent and where is it commonly used?

Under what clinical circumstances is E0191 typically ordered and what are the typical workflow steps?

Which billing modifiers are referenced for use with E0191?

Which payers are referenced and how is E0191 categorized for reimbursement?

What related CPT codes are listed and how do they relate to billing for E0191?

References