HCPCS Level II E1037: Pediatric Transport Chair - OpenPayer

Summary & Overview

HCPCS Level II E1037: Pediatric Transport Chair

HCPCS Level II code E1037 denotes a pediatric-sized transport chair, categorized as durable medical equipment (DME) used to provide seated mobility for children in outpatient, home, school, and community settings. Nationally, accurate coding for pediatric transport chairs affects access to appropriate mobility devices, coverage determinations, and coordination between clinicians, suppliers, and payers.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical coverage considerations and where this code fits in clinical and billing workflows. The publication outlines common billing practices, expected sites of service, and the clinical context in which a pediatric transport chair is supplied. It also identifies the primary use cases for pediatric transport chairs and how the code facilitates claims processing for durable medical equipment.

This resource is intended to help billing specialists, DME suppliers, and policy analysts understand the role of HCPCS Level II code E1037, what information is typically required on claims, and the broader implications for supply and access at a national level. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE1037HCPCS Level IIDurable Medical EquipmentPediatric MobilityTransport ChairDME BillingMedical Equipment Coding

Billing Code Overview

HCPCS Level II code E1037 describes a transport chair, pediatric size. This item is a mobility assist device designed for children who require a lightweight, portable seating and transport solution.

Service type: Durable Medical Equipment (DME)

Typical site of service: Outpatient settings, home use, schools, and community mobility environments

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A pediatric patient with limited mobility due to a neuromuscular disorder or developmental disability requires a transport chair for community mobility and short-distance transfers. Typical patients include children with cerebral palsy, spina bifida, muscular dystrophy, or significant orthopedic injuries that preclude safe ambulation. The clinical workflow begins with a pediatrician, pediatric physiatrist, or pediatric orthopedic specialist identifying mobility limitations and documenting functional deficits and medical necessity. A physical therapy or occupational therapy assessment documents measurements (seat width, depth, back height), positioning needs, and recommended accessories. The durable medical equipment (DME) supplier submits documentation to the payor (for example, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare) including the prescription, patient measurements, therapist assessment, trial notes if applicable, and justification that a pediatric transport chair (E1037) is the most appropriate device versus alternatives. Delivery occurs with fitting, caregiver training, and documentation of medical necessity and fitting in the patient record.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Standard use when no specific modifier applies.

HCPCS E0480: Percussor, Electric or Pneumatic, Home Model

HCPCS-E2331-POWER-WHEELCHAIR-ATTENDANT-PROPORTIONAL-CONTROL

HCPCS Level II E2331: Power Wheelchair Attendant Proportional Control

HCPCS-E2512-SPEECH-GENERATING-DEVICE-MOUNTING-SYSTEM

HCPCS E2512: Accessory for Speech Generating Device, Mounting System

HCPCS-E0620-SKIN-PIERCING-DEVICE-CAPILLARY-BLOOD-LASER

HCPCS Level II E0620: Skin Piercing Device for Capillary Blood Collection, Laser

HCPCS-E1828-DYNAMIC-ADJUSTABLE-TOE-EXTENSION-DEVICE-SOFT-INTERFACE

HCPCS Level II E1828: Dynamic Adjustable Toe Extension Device

HCPCS-E0955-WHEELCHAIR-HEADREST-CUSHIONED

HCPCS E0955: Wheelchair Cushioned Headrest, Including Mounting Hardware

HCPCS-E0930-FRACTURE-FRAME-FREE-STANDING-WITH-WEIGHTS

HCPCS E0930: Fracture Frame, Free Standing, Includes Weights

HCPCS-E1825-DYNAMIC-FINGER-EXTENSION-FLEXION-DEVICE

HCPCS Level II E1825: Dynamic Adjustable Finger Extension and Flexion Device

HCPCS-E2310-POWER-WHEELCHAIR-SEATING-CONNECTION-ACCESSORY

HCPCS E2310: Power Wheelchair Seating Connection Accessory

HCPCS-E1353-REGULATOR-DURABLE-MEDICAL-EQUIPMENT

HCPCS E1353: Regulator for Durable Medical Equipment

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Taxonomy Code	Specialty	Notes
`207RP0000X`	Physical Medicine & Rehabilitation (Physiatry)	Common ordering specialty for mobility equipment and functional assessments.
`208800000X`	Pediatric Medicine	Pediatricians often originate requests and coordinate care.
`223100000X`	Physical Therapy	Therapists provide formal assessments, measurements, and justification for device selection.
`251B00000X`	Orthopedic Surgery	Pediatric orthopedic surgeons may prescribe transport chairs for post-operative mobility or deformity management.
`3336C0003X`	Durable Medical Equipment Supplier	DME supplier taxonomy used for billing and delivery of `E1037`.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G80.0`	Spastic quadriplegic cerebral palsy	Severe motor impairment often necessitates a pediatric transport chair for safe mobility and transfers.
`G80.2`	Spastic diplegic cerebral palsy	Ambulation limited; transport chair may be required for community participation and safety.
`Q05.9`	Spina bifida, unspecified	Neurologic deficits causing mobility impairment where a pediatric transport chair provides functional mobility.
`G71.0`	Muscular dystrophy	Progressive muscle weakness often requires mobility aids including pediatric transport chairs for safety.
`M62.81`	Muscle weakness (generalized)	Documented weakness that limits ambulation and justifies a transport chair for short-distance mobility.
`S72.001A`	Fracture of unspecified part of neck of right femur, initial encounter	Acute orthopedic injury that temporarily necessitates a transport chair during recovery.
`R26.2`	Difficulty in walking, not elsewhere classified	Functional limitation code supporting medical necessity for a transport chair.
`R26.89`	Other abnormalities of gait and mobility	Supports need for pediatric transport chair when documented by clinician or therapist.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97161`	Physical therapy evaluation, low complexity	Initial PT evaluation that may document mobility limitations and justify `E1037` when complexity is low.
`97162`	Physical therapy evaluation, moderate complexity	PT evaluation commonly used to support need for a pediatric transport chair with moderate assessment complexity.
`97110`	Therapeutic exercises	Therapy interventions to improve strength and mobility; may be part of the clinical record supporting equipment need.
`97530`	Therapeutic activities	Functional activities documented in therapy notes that support the need for a transport chair for community mobility.
`99354`	Prolonged service in the office (direct patient contact)	Used if extended clinician evaluation time is documented to assess mobility and equipment needs.

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