Summary & Overview
HCPCS E1222: Wheelchair with Fixed Arm, Elevating Legrests
HCPCS Level II code E1222 denotes a wheelchair with fixed armrests and elevating legrests, a commonly used durable medical equipment item for patients needing mobility assistance and leg elevation. Nationally, this code matters because it informs coverage determinations, durable medical equipment provisioning, and billing for mobility devices that affect patient function and care needs across home and long-term care settings. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what E1222 represents, typical sites of service, and which major payers are addressed. The publication presents benchmarks and policy-relevant considerations related to coverage and billing for wheelchairs with elevating legrests, outlines common clinical contexts in which such devices are used, and summarizes typical payer practices where available. Data not provided in the input are noted as unavailable and not inferred. The aim is to give clinicians, billing professionals, and policy analysts a clear reference for coding and service classification of E1222 in national payer contexts.
Billing Code Overview
HCPCS Level II code E1222 describes a wheelchair with fixed arm and elevating legrests. This device is a durable medical equipment item intended to provide mobility and postural support for patients who require seated mobility and need legs elevated for comfort, circulation, or clinical care.
Service type: Durable medical equipment (wheelchair)
Typical site of service: Home or community settings, including patient residences and long-term care facilities where durable mobility equipment is used for activities of daily living.
Clinical & Coding Specifications
Clinical Context
A 76-year-old patient with progressive osteoarthritis of both hips and limited ambulatory capacity is evaluated in a durable medical equipment clinic. The patient uses a standard manual wheelchair at home but reports increasing difficulty with transfers and leg edema. A clinician documents the need for a wheelchair with fixed arms and elevating legrests to provide lower-extremity elevation for edema control and to facilitate safer transfers and positioning. The clinical workflow includes: a clinician evaluation and documentation of mobility limitations, therapeutic goals (pressure relief, edema management, safe transfers), measurement for appropriate seat width and legrest length, prior authorization submission to the patient’s payer with supporting notes and diagnosis, delivery and patient/caregiver training on legrest adjustments, and follow-up to confirm fit and function. Typical site of service is an outpatient DME supplier or home health/ambulatory equipment clinic with delivery to the patient’s residence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default billing indicator | Use as the standard submission when no other modifier applies. |
22 | Unusual procedural services |