Summary & Overview
HCPCS Level II E1160: Wheelchair with Fixed Full-Length Arms, Elevating Legrests
HCPCS Level II code E1160 denotes a manual wheelchair with fixed full-length arms and swing-away detachable elevating legrests. This DME code is relevant nationally for patients needing mobility devices that provide arm support and leg elevation, such as those recovering from lower-extremity injury or managing chronic conditions requiring leg elevation. The code matters for coverage determinations, durable medical equipment suppliers, and clinicians coordinating durable mobility solutions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of E1160, payer coverage considerations, common billing modifiers, and how this code fits within the DME service line. The publication also presents benchmark billing elements and policy updates that affect reimbursement processes and documentation requirements.
This summary equips billing professionals, DME suppliers, and health policy analysts with essential information on clinical indications, typical sites of service, and administrative context for HCPCS Level II code E1160. Data not available in the input is noted where applicable in the full publication.
Billing Code Overview
HCPCS Level II code E1160 describes a wheelchair with fixed full-length arms and swing-away detachable elevating legrests. The service represented is durable medical equipment (DME) providing mobility assistance for patients who require a manual wheelchair with full arm support and adjustable, detachable elevating legrests. Typical site of service includes outpatient settings, home use, durable medical equipment suppliers, and skilled nursing facilities where patients receive mobility devices for daily activities or post-acute recovery.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with advanced osteoarthritis of both knees and limited lower-extremity strength requires a durable medical equipment wheelchair. The provider documents limited ambulatory ability, inability to safely ambulate in the community, and need for a wheelchair with fixed full-length armrests and swing-away detachable elevating legrests to support transfers and leg elevation for edema or post-surgical swelling. The clinical workflow begins with a face-to-face evaluation by a physician, physical therapist, or other qualified practitioner documenting functional mobility deficits, strength, balance, and home environment barriers. A detailed order specifying E1160 (wheelchair, fixed full length arms, swing away detachable elevating legrests) is completed and submitted with supporting documentation and relevant ICD-10 diagnosis codes to the durable medical equipment supplier. The supplier verifies Medicare or commercial payer coverage criteria, completes a mobility/functional assessment, and delivers the wheelchair with appropriate adjustments and training. Follow-up includes verification of fit, patient education on transfers and safe use of the elevating legrests, and documentation of medical necessity in the medical record for reimbursement and durable medical equipment program compliance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |