Summary & Overview
HCPCS Level II E1814: Dynamic Adjustable Knee Flexion Device, Soft Interface
HCPCS Level II code E1814 represents a dynamic adjustable knee flexion-only orthotic device that includes soft interface material. Such devices are used to provide controlled knee flexion, aid rehabilitation after injury or surgery, and support functional mobility. Nationally, coding and coverage for orthotic devices like E1814 affect patient access to rehabilitation equipment and influence outpatient and home-based care planning.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical uses and settings for the device, payer coverage considerations, typical service settings, and commonly used modifiers. The publication also presents benchmark reimbursement context and policy updates that influence claims processing and authorization requirements.
Readers will learn how the device is described and billed, which payer categories commonly cover such orthoses, and where to look for policy nuances that affect prior authorization and durable medical equipment claims. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E1814 describes a dynamic adjustable knee flexion only device that includes soft interface material. The device provides controlled, adjustable flexion support for the knee joint, designed to allow motion while providing therapeutic positioning and resistance.
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Service type: Durable medical equipment / orthotic device for knee flexion support
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Typical site of service: Outpatient clinics, orthopedic or rehabilitation specialty practices, and home use following prescription
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with persistent knee flexion contracture and concomitant quadriceps weakness following a traumatic supracondylar femur fracture presents to an outpatient orthotics clinic. The patient reports difficulty achieving functional knee flexion during gait and stiffness that limits activities of daily living. After orthopedic evaluation and documented range-of-motion deficits, an orthotist measures the patient and provisions a E1814 dynamic adjustable knee flexion-only device with soft interface material to assist controlled flexion therapy while protecting the knee joint.
The clinical workflow includes: initial orthopedic or physiatry evaluation with documented diagnosis and functional limitations; referral to a certified orthotist; orthotic assessment including limb measurements and goals of treatment (improve flexion ROM, assist with controlled eccentric loading, reduce pain); device fabrication or adjustment visit; patient education on donning, doffing, cleaning, and activity limitations; follow-up visits for progressive adjustment of tension and range settings; and periodic documentation of functional improvement and any skin/interface issues. The device is typically applied in outpatient orthotics/prosthetics clinics, rehabilitation clinics, or hospital-based orthotics services and is used as part of a conservative management plan including physical therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |