Summary & Overview
HCPCS E1016: Shock Absorber for Power Wheelchair, Each
HCPCS Level II code E1016 represents a shock absorber for a power wheelchair, billed per unit. This accessory matters nationally because it directly affects mobility device function, user comfort, and device longevity, and it is commonly processed across commercial and public payers. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what E1016 covers clinically, common settings where the item is supplied, and the payer landscape for coverage and billing practices. The publication outlines typical billing modifiers and ancillary information (listed elsewhere) that influence claim adjudication, as well as related device considerations and service-line placement for durable medical equipment suppliers. The content highlights benchmarks and policy-relevant elements such as national coverage implications, documentation expectations, and how this component fits into broader mobility device provisioning. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E1016 describes a shock absorber for power wheelchair, each. This supply is a component designed to absorb shock and reduce vibration transmitted to the wheelchair frame and occupant, improving comfort and protecting the mobility device.
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Service type: Durable medical equipment component / mobility device accessory
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Typical site of service: Durable medical equipment suppliers, outpatient durable equipment fitting locations, home delivery and installation where mobility devices are serviced
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Clinical & Coding Specifications
Clinical Context
A power wheelchair user with chronic mobility limitations presents to a durable medical equipment (DME) supplier or wheelchair repair clinic for maintenance after experiencing increased vibration and reduced ride comfort. The patient typically has a diagnosis such as spina bifida, spinal cord injury, multiple sclerosis, advanced arthritis, or other neuromuscular disorders necessitating a power wheelchair. During a clinical assessment by a DME clinician or wheelchair technician, the clinician documents worn or failed suspension components on the power wheelchair and orders replacement shock absorbers. The service involves evaluation of the wheelchair, removal of the defective shock absorber(s), and installation of new shock absorber(s). Billing uses HCPCS Level II code E1016 for each shock absorber replaced. Typical site of service is an outpatient DME supplier, wheelchair repair shop, or the patient’s home when the vendor provides in-home service. The workflow includes verification of patient eligibility, confirmation of the wheelchair make/model and part compatibility, capture of serial numbers and modifier information, performance of the repair/replacement, and documentation of the labor, part number, quantity (each shock absorber billed separately), and clinical justification for the replacement in the patient record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced Services | Use when a partial repair/service is performed that is less than the full replacement service. |