E0967 Manual Wheelchair Hand Rim — HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS E0967: Manual Wheelchair Hand Rim with Projections, Replacement Only

HCPCS Level II code E0967 covers replacement hand rims with projections for manual wheelchairs — a durable medical equipment accessory intended to improve user grip and propulsion. Nationally, this code matters because it addresses mobility, safety, and independence for individuals who use manual wheelchairs and represents a common replacement item within the mobility aids supply chain.

Key payers included in the coverage analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role and service context, payer coverage landscape, and typical sites of service. The publication outlines common billing considerations, relevant modifiers and claims practices, and where reimbursement policy updates could affect access to replacement components.

The report provides benchmarks for utilization and payment practices where available, highlights policy and coverage drivers that influence replacement frequency and documentation, and presents clinical context about why projected hand rims are prescribed. Data limitations are noted when input details are absent. This summary equips billing specialists, DME suppliers, mobility clinicians, and policy analysts with the practical information needed to code, document, and understand coverage dynamics for E0967.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE0967HCPCS Level IImanual wheelchair accessorydurable medical equipmentmobility aidsreplacement partswheelchair hand rimprosthetics-orthoticsmedical billing

Billing Code Overview

HCPCS Level II code E0967 describes a manual wheelchair accessory: hand rim with projections, intended as a replacement part supplied per item. The accessory is designed to improve manual propulsion by offering enhanced grip or tactile feedback via projections on the hand rim surface.

Service type: Durable medical equipment accessory, replacement part.

Typical site of service: Durable medical equipment supplier, outpatient orthotics/prosthetics or mobility clinic, and community/home use after provision.

Clinical & Coding Specifications

Clinical Context

A 68-year-old ambulatory outpatient uses a manual wheelchair for mobility due to long-standing spinal cord injury and progressive upper‑extremity osteoarthritis. During a routine durable medical equipment (DME) service appointment, the patient reports decreased braking efficiency and frequent hand slippage while propelling the chair. The DME technician inspects the wheelchair and identifies worn, damaged, or missing hand rim projections (protruding grips) that provide additional traction for the user. The technician replaces the single damaged hand rim projection component under warranty or as a billed replacement item using billing code E0967 (manual wheelchair accessory, hand rim with projections, any type, replacement only, each).

The clinical workflow includes: physician or therapist documentation of medical necessity for continued manual propulsion, prescription/order for replacement accessory, DME supplier verification of wheelchair make/model and fit, procurement and replacement of the hand rim projection, and documentation of item replaced, serial numbers, and patient acceptance. The supplier records the billing code E0967, attaches relevant modifier(s) if applicable, and maintains proof of delivery and supplier notes in the patient chart for reimbursement and audit purposes.

Coding Specifications

Modifier	Description	When to Use
`00`

HCPCS E1353: Regulator for Durable Medical Equipment

HCPCS-E0140-WALKER-TRUNK-SUPPORT-ADJUSTABLE-FIXED-HEIGHT

HCPCS E0140: Walker with Trunk Support, Adjustable or Fixed Height

HCPCS-E0983-POWER-ADD-ON-CONVERT-MANUAL-WHEELCHAIR-JOYSTICK

HCPCS E0983: Power Add-on to Convert Manual Wheelchair to Motorized

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

HCPCS Level II E0786: Implantable Programmable Infusion Pump, Replacement

HCPCS-E0954-WHEELCHAIR-FOOT-BOX-ACCESSORY

HCPCS E0954: Wheelchair Foot Box Accessory, Per Foot

HCPCS-E0148-HEAVY-DUTY-WALKER-WITHOUT-WHEELS

HCPCS E0148: Heavy-Duty Walker Without Wheels

HCPCS-E0641-STANDING-FRAME-TABLE-SYSTEM-MULTI-POSITION

HCPCS E0641: Multi-Position Standing Frame/Table System

HCPCS-E1171-AMPUTEE-WHEELCHAIR-FIXED-FULL-LENGTH-ARMS

HCPCS E1171: Amputee Wheelchair with Fixed Full-Length Arms

HCPCS-E1816-ANKLE-STATIC-PROGRESSIVE-STRETCH-DEVICE

HCPCS E1816: Static Progressive Ankle Stretch Device

HCPCS-E0235-PARAFFIN-BATH-UNIT-PORTABLE

HCPCS E0235: Paraffin Bath Unit, Portable

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Taxonomy Code	Specialty	Notes
`261QM0800X`	Physical Medicine & Rehabilitation Physician	Physicians who prescribe mobility devices and document medical necessity.
`3336C0002X`	Durable Medical Equipment & Medical Supplies Supplier	Suppliers who bill for wheelchair accessories and perform replacement.
`208100000X`	Physical Therapist	Therapists who evaluate mobility needs and recommend accessory modifications.
`208VP0006X`	Occupational Therapist	Occupational therapists who assess propulsion technique and recommend hand rim projections.
`363L00000X`	Prosthetist/Orthotist	Professionals who may fit and customize wheelchair accessories.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M19.90`	Osteoarthritis, unspecified site, unspecified	Degenerative joint disease of the upper extremity that impairs hand strength and grip, increasing need for hand rim projections.
`M47.817`	Spondylosis without myelopathy or radiculopathy, thoracic region	Spinal degenerative disorder resulting in mobility limitations and long‑term wheelchair use where accessory replacement may be needed.
`G82.20`	Paraplegia, unspecified	Motor impairment requiring manual wheelchair use; hand rim projections improve propulsion safety and efficiency.
`G82.50`	Quadriplegia, unspecified	Significant motor impairment where specialized hand rims may be required for effective propulsion by remaining upper‑extremity function.
`R26.2`	Difficulty in walking, not elsewhere classified	Ambulatory impairment prompting use of a manual wheelchair and potential replacement of propulsion accessories.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes	Used by therapists to evaluate and train the patient in manual propulsion and hand rim use after replacement.
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility, each 15 minutes	Performed by physical therapists to address upper‑extremity strength deficits that affect wheelchair propulsion and may justify accessory replacement.
`97760`	Orthotic(s) management and training (including assessment and fitting when performed), lower extremity, upper extremity, and/or trunk prosthetic training, initial encounter, each 15 minutes	Used when an orthotist/prosthetist evaluates or fits custom hand rim projections or related fittings.
`99070`	Supplies and materials (e.g., bandages, casts, splints), used by the physician or other qualified health care professional, when not included in the procedure	Used to bill non‑capital supplies related to the fitting or adjustment of the hand rim accessory.
`G0379`	Physician-certified durable medical equipment primary payer claim review	Used in administrative contexts for DME certification and documentation review preceding replacement.

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