Summary & Overview
HCPCS Level II E1038: Transport Chair, Adult Up to 300 Pounds
HCPCS Level II code E1038 designates an adult transport chair with a patient weight capacity up to and including 300 pounds. As a category of durable medical equipment, this code matters nationally because transport chairs are commonly used across care settings for patient movement, discharge planning, and outpatient mobility needs. Clear coding supports correct benefit determination, durable medical equipment management, and operational planning for providers and suppliers.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for E1038, common sites of service and service type, and what to expect when this equipment is billed. The publication summarizes national benchmarking considerations, payer coverage patterns, and notable policy or documentation elements that typically affect payment determinations. Where input data is missing, the report notes that specific details are not available in the input.
This summary provides clinicians, billing staff, and DME suppliers with the core facts about the code, an outline of typical workplaces and clinical uses, and pointers to the types of benchmarking and policy issues covered in the full publication.
Billing Code Overview
HCPCS Level II code E1038 describes a transport chair, adult size, patient weight capacity up to and including 300 pounds. This code represents durable medical equipment intended to assist with short-distance mobility and transport of adult patients who can be seated but require a lightweight, portable chair for movement within facilities or during travel.
Service type: Durable Medical Equipment (DME) — transport chair
Typical site of service: Outpatient settings, ambulatory clinics, long-term care facilities, nursing homes, and patient residences where a transport chair is used for transfers or short-distance mobility.
Clinical & Coding Specifications
Clinical Context
An adult patient with limited mobility and diminished ability to ambulate independently requires a transport chair for short-distance, attendant-propelled movement within medical facilities or community settings. Typical patients include those recovering from medical procedures, with deconditioning after hospitalization, neurologic weakness, balance impairment, or cardiopulmonary limitations that make independent ambulation unsafe. The clinical workflow begins with an outpatient or inpatient clinician assessment documenting functional limitation and medical necessity for a transport chair (E1038) — including weight capacity requirement (up to and including 300 pounds). A durable medical equipment (DME) supplier verifies prescription details, delivers the chair sized for an adult patient, and provides basic instruction for the patient and caregiver on safe transfer and attendant propulsion. Follow-up occurs as part of routine care coordination to ensure continued suitability of the device and to address repairs or replacement as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Used when no modifier applies to the billing for the item |
52 |