Summary & Overview

HCPCS E1007: Power Seating System, Combination Tilt and Recline

HCPCS Level II code E1007 identifies a wheelchair accessory: a powered seating system that combines tilt and recline with mechanical shear reduction. This equipment affects mobility, skin protection, and seating comfort for patients who require complex positioning support. Nationally, E1007 matters because powered seating features can influence clinical outcomes (pressure management, postural support) and represent significant durable medical equipment (DME) costs and utilization considerations for payers and providers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what E1007 denotes, typical clinical contexts for use, and the service settings where such accessories are supplied. The publication outlines payer coverage considerations and benchmarking context where available, plus coding and billing nuances relevant to DME suppliers and clinical teams.

This summary provides clinicians, billing professionals, and policy analysts with: a concise definition of the device and its clinical purpose; the typical sites of service and service type; and guidance on the topics addressed further in the publication, including reimbursement benchmarks, coverage policy themes, and clinical implications for pressure management and mobility.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE1007HCPCS Level IIwheelchair accessorypower seatingtilt and reclinemechanical shear reductiondurable medical equipmentDMEmobility aids

Billing Code Overview

HCPCS Level II code E1007 describes a wheelchair accessory: power seating system, combination tilt and recline, with mechanical shear reduction. This item is an accessory to a mobility device that provides powered adjustments for both tilt and recline functions and incorporates mechanical features designed to reduce shear forces on the user during position changes.

Service Type: Durable Medical Equipment — Wheelchair Accessory (power seating system)

Typical Site of Service: Home, outpatient durable medical equipment settings, or any clinical environment where a mobility device is fitted and serviced.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with advanced Parkinson disease and progressive postural instability is evaluated by a durable medical equipment (DME) provider and a rehabilitation physician for mobility and seating needs. The patient demonstrates significant trunk weakness, frequent forward and posterior tipping, and skin breakdown risk at the sacrum despite conservative interventions. The interdisciplinary workflow includes a physician order for a powered wheelchair with a power seating system, a DME assessment documenting functional mobility deficits, measurements for customized seating, and justification for a combination tilt and recline mechanism with mechanical shear reduction. The DME supplier obtains prior authorization from payors, captures photos and pressure-mapping data, provides a trial when feasible, and delivers the accessory once approved. Follow-up visits document seating adjustments, skin integrity status, and any changes in functional status that might necessitate modification or replacement of the power seating accessory.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier reported	Use as default when no other modifier applies.
`22`	Increased procedural services	Use when significantly more work is required for customization or complex seating modifications beyond typical.
`23`	Unusual anesthesia	Not commonly used for DME accessories; only if unusual anesthesia is required during a related procedure.
`26`	Professional component	Use when billing separates professional assessment (e.g., clinician seating evaluation) from technical supply.
`52`	Reduced services	Use if the accessory is provided with reduced features or partial functionality compared to standard.
`53`	Discontinued procedure	Use if the seating fitting or delivery was started but discontinued for patient-related reasons.
`62`	Two surgeons	Rare for this supply; use only when two qualified practitioners jointly provide components of the service.
`78`	Return to the operating/procedure room for a related procedure by same physician	Use only if a surgical/procedural revision related to seating occurs in same global period.
`80`	Assistant at surgery	Not typical for DME supply; include only if an assistant is legitimately billed for a related procedure.
`82`	Assistant not available	Use when a qualified assistant is unavailable for a related procedure and billing rules permit.
`76`	Repeat procedure by same physician	Not in the original list; omitted per input constraints.
`RR`	Rental not available	Use when reporting return rental or related modifier per payer instructions (select when applicable).
`NU`	New equipment	Use to indicate the item is new and not refurbished.
`UE`	Left sided component	Use when laterality coding applies to a component where payor requires sided reporting.

Taxonomy Code	Specialty	Notes
`2080P0207X`	Physical Medicine & Rehabilitation Physician	Performs seating evaluations and writes orders for power seating systems.
`207RC0000X`	Rehabilitation Services, Physical Therapist	Conducts functional mobility and seating assessments, pressure mapping, and trials.
`3336C0003X`	Durable Medical Equipment Supplier	Provides measurement, fabrication, delivery, and maintenance of the power seating accessory.
`243ZP0108X`	Occupational Therapist	Evaluates activities of daily living, seating positioning, and recommends control interfaces.
`261QM0800X`	Orthotist/Prosthetist	Provides custom seating components, cushions, and mechanical shear-reducing interfaces.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G20`	Parkinson disease	Common progressive neurological disorder causing postural instability and need for powered tilt/recline seating with shear reduction.
`G82.20`	Paraplegia, unspecified	Patients with lower extremity paralysis often require power seating systems for pressure management and posture.
`G83.4`	Cauda equina syndrome	Neurologic deficits causing severe mobility impairment and need for specialized seating to prevent tissue shear.
`M48.06`	Spinal stenosis, lumbar region	Causes neurogenic claudication and weakness that may necessitate powered mobility and specialized seating.
`R26.2`	Difficulty in walking, not elsewhere classified	Functional gait limitations that support the medical necessity of a power seating system.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97161`	Physical therapy evaluation, low complexity	Performed prior to seating prescription to document functional impairments and justify power seating needs.
`97162`	Physical therapy evaluation, moderate complexity	Used when the assessment requires moderate complexity and supports custom seating recommendations.
`97760`	Orthotic management and training, initial encounter	Includes instruction and training for use of seating components and power wheelchair controls.
`99456`	Work related or medical disability examination services (by physician)	May be used when documenting functional capacity related to disability determinations influencing equipment necessity.
`97763`	Orthotic/prosthetic training, subsequent	Used for follow-up training and adjustments after delivery of the seating accessory.