Summary & Overview
HCPCS E1028: Wheelchair Swingaway Mounting Hardware, Manual
HCPCS Level II code E1028 denotes a wheelchair accessory: a manual swingaway component with retractable or removable mounting hardware. This code is used to identify and bill for components that facilitate armrest or device swingaway functions to aid transfers, positioning, and caregiver access. Nationally, proper coding of wheelchair accessories affects equipment coverage, supplier reimbursement, and patient access to mobility aids.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose, typical service settings, and which payers are commonly involved. The publication includes benchmark guidance for billing and coverage, common payer policy considerations, and the clinical context for when swingaway mounting hardware is used with manual wheelchairs.
This summary equips billing staff, durable medical equipment suppliers, and clinical teams with the essential context for HCPCS Level II code E1028, including common reimbursement and policy themes, documentation points typically associated with accessory provision, and where to look for payer-specific rules. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E1028 describes a wheelchair accessory: a manual swingaway component with retractable or removable mounting hardware. The code covers add-on parts that allow wheelchair armrests or related fittings to pivot or swing away for transfers and positioning.
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Service type: Durable medical equipment accessory for mobility devices
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Typical site of service: Use is associated with outpatient, home, and durable medical equipment supply settings where wheelchairs and accessories are furnished or adjusted by suppliers, therapists, or durable medical equipment providers.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with long-standing lumbar spinal stenosis and limited lower extremity strength uses a manual rigid-frame wheelchair for community mobility. The patient reports difficulty with transporting the wheelchair in his vehicle because the fixed footrests and mounting hardware increase width and obstruct folding. A durable medical equipment (DME) specialist evaluates the wheelchair and documents that installing a manual swingaway, retractable or removable mounting hardware accessory will allow the footrests to swing away or be removed quickly, improving transfers, vehicle docking, and storage without altering the primary seating or mobility system. The clinical workflow includes: a DME evaluation and measurement session; documentation of functional need and mobility goals; selection of the appropriate E1028 accessory compatible with the existing wheelchair; ordering and billing by the supplier; delivery and fitting in the patient’s home or clinic; and a short training session with the patient and caregiver on use, safe removal/reinstallation, and maintenance. Typical sites of service are outpatient DME supplier locations, patient homes, rehabilitation clinics, and skilled nursing facilities. Patient education, a signed DME order, and photos or a face-to-face evaluation note are included in the item record to support medical necessity and appropriate fitting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |