E2206 Wheel Lock Assembly | HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II E2206: Manual Wheelchair Wheel Lock Assembly, Replacement Only

HCPCS Level II code E2206 denotes a replacement wheel lock assembly for manual wheelchairs. As a durable medical equipment accessory code, it identifies billing for single, complete wheel lock units used to restore or maintain wheelchair safety and function. Nationally, accurate coding of wheelchair accessories like E2206 matters for ensuring beneficiaries receive necessary repairs and for consistent reimbursement across suppliers and payers.

Key payers commonly engaged with this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication summarizes coverage and billing context for those payers, outlines common billing modifiers and reporting conventions, and provides clinical context for when replacement assemblies are appropriate.

Readers will learn how E2206 fits into durable medical equipment billing workflows, what service settings typically bill this code, and the types of benchmarks and policy considerations relevant to suppliers and clinical teams. Data not available in the input will be identified as such in dedicated sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2206HCPCS Level IIdurable medical equipmentwheelchair accessorywheel lock assemblyequipment replacementDME billingrepair services

Billing Code Overview

HCPCS Level II code E2206 describes a manual wheelchair accessory: a wheel lock assembly, complete, replacement only, each. This item is a component replacement for manual wheelchairs that restores or maintains the function of the wheel locking mechanism.

Service type: Durable medical equipment accessory replacement
Typical site of service: Durable medical equipment suppliers, wheelchair repair shops, outpatient durable medical equipment clinics, and home delivery/installation settings

Clinical & Coding Specifications

Clinical Context

A community-dwelling adult patient who uses a manual wheelchair reports that one wheel lock assembly on their primary wheelchair is worn and no longer secures the wheel reliably. The durable medical equipment (DME) supplier receives a request from the prescribing clinician (often a physiatrist, orthopedic surgeon, or primary care physician) to replace the wheel lock assembly. The supplier verifies the wheelchair make/model and documents the need for replacement parts in the beneficiary’s file, including photos or technician notes confirming worn or broken components. The wheelchair technician orders and installs the replacement wheel lock assembly billed as E2206 (manual wheelchair accessory, wheel lock assembly, complete, replacement only, each). Typical workflow includes verification of prior authorization when required by the payor, confirmation of medical necessity tied to the patient’s mobility impairment, scheduling of installation either in clinic or at the patient’s residence, and documentation of the replaced part, serial number, and a dated technician signature. Usual sites of service are outpatient DME supplier locations, outpatient clinics, home visits, or skilled nursing facilities where the wheelchair is used and maintained.

Coding Specifications

Modifier	Description	When to Use
`59`	Data not available in the input.	Data not available in the input.

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HCPCS-E0218-FLUID-CIRCULATING-COLD-PAD-PUMP

HCPCS Level II E0218: Fluid Circulating Cold Pad with Pump

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HCPCS E1800: Dynamic Adjustable Elbow Extension and Flexion Device

HCPCS-E0691-ULTRAVIOLET-LIGHT-THERAPY-SYSTEM-LOCALIZED

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HCPCS-E2619-REPLACEMENT-WHEELCHAIR-CUSHION-COVER

HCPCS E2619: Replacement Cover for Wheelchair Seat or Back Cushion

HCPCS-E0276-BED-PAN-FRACTURE-METAL-PLASTIC

HCPCS Level II E0276: Bed Pan for Fracture, Metal or Plastic

HCPCS-E0292-HOSPITAL-BED-VARIABLE-HEIGHT-HI-LO-WITHOUT-SIDE-RAILS-WITH-MATTRESS

HCPCS E0292: Hospital Bed, Variable Height Hi‑Lo Without Side Rails

HCPCS-E1841-STATIC-PROGRESSIVE-SHOULDER-STRETCH-DEVICE

HCPCS E1841: Static Progressive Shoulder Stretch Device

HCPCS-E0373-NONPOWERED-ADVANCED-PRESSURE-REDUCING-MATTRESS

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Taxonomy Code	Specialty	Notes
`174100000X`	Physical Medicine & Rehabilitation (Physiatry)	Prescribers of complex mobility devices and replacement accessories.
`208800000X`	Orthopedic Surgery	Clinicians managing musculoskeletal conditions that impact mobility and wheelchair needs.
`261QM0800X`	Durable Medical Equipment & Medical Supply	DME suppliers and technicians responsible for ordering and installing replacement wheelchair components.
`207Q00000X`	Family Medicine	Primary care clinicians who may document medical necessity and prescribe DME accessories.
`207L00000X`	Internal Medicine	Internists who manage chronic conditions contributing to mobility impairment and DME prescriptions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z99.3`	Dependence on wheelchair	Common primary code indicating the patient uses a wheelchair; supports medical necessity for replacement wheelchair parts.
`G82.50`	Paraplegia, unspecified, lower limb paralysis, unspecified	Patients with lower-limb paralysis frequently use manual wheelchairs and require functional wheel locks for safety.
`G81.90`	Hemiplegia, unspecified affecting unspecified side	Hemiplegia patients using manual wheelchairs may need reliable wheel locks to prevent falls during transfers.
`M62.81`	Muscle weakness (generalized)	Muscle weakness can affect a patient’s ability to stabilize a wheelchair, making wheel lock integrity clinically important.
`R26.89`	Other abnormalities of gait and mobility	Mobility impairment diagnoses that justify wheelchair use and subsequent accessory maintenance or replacement.
`Z74.01`	Bed confinement status	Indicates limited mobility where wheelchair equipment maintenance is necessary for safe transfers and positioning.
`Z96.641`	Presence of right artificial hip joint	Example comorbidity that may increase reliance on a wheelchair and the need for safe, functioning locks.
`Z96.642`	Presence of left artificial hip joint	As above for the contralateral side, relevant to mobility limitations and equipment maintenance.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedure	Used when clinicians supply minor replacement parts or materials during an office-based repair visit in addition to billing for the DME part.
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	May be billed by therapy clinicians who perform wheelchair and seating assessments before ordering replacement components to ensure safety and function.
`97161`	Physical therapy evaluation: low complexity	Billed when a physical therapist evaluates the patient’s mobility needs related to wheelchair safety and documents the need for a replacement part.
`99441`	Telephone evaluation and management service provided by a physician or other qualified health care professional 5-10 minutes of medical discussion	May be used for telephonic triage or authorization discussions about the need for replacement parts prior to in-person service.
`99080`	Special reports such as insurance forms, more than the usual information required for routine reports	Used for preparing documentation required by payors to support medical necessity of the replacement accessory.

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