E2212 Manual Wheelchair Tire Tube Reimbursement | OpenPayer

Summary & Overview

HCPCS E2212: Manual Wheelchair Pneumatic Tire Tube

HCPCS Level II code E2212 denotes a replacement tube for pneumatic propulsion tires used on manual wheelchairs. As a common durable medical equipment (DME) accessory, this code matters nationally because it supports mobility maintenance and continuity of care for wheelchair users, and it factors into DME procurement, repair logistics, and supplier reimbursement workflows.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what the code covers clinically, typical sites of service, and which payers commonly process claims for this supply item. The publication outlines benchmark elements such as coverage considerations, billing context, and common modifiers used with HCPCS Level II supplies (where available). It also summarizes practical billing implications for suppliers and billing staff, including coding accuracy and claim submission points.

This summary is written for a national audience and provides an overview of the clinical purpose of the item, payer coverage landscape, and the billing context that affects reimbursement and supply management for manual wheelchair pneumatic tire tubes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2212HCPCS Level IIdurable medical equipmentwheelchair accessorypneumatic tire tubeDME billingmobility aidswheelchair maintenancemedical supplies

Billing Code Overview

HCPCS Level II code E2212 describes a manual wheelchair accessory: tube for pneumatic propulsion tire, any size, each. This item is an accessory component intended for manual wheelchairs that use pneumatic tires and provides a replacement or spare tube for the propulsion tire.

Service type: Durable medical equipment accessory; supply for manual wheelchair tire maintenance and repair
Typical site of service: Durable medical equipment supplier, outpatient clinic, home use (delivered/installed by DME supplier)

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or pediatric wheelchair user whose manual wheelchair pneumatic tire tube is punctured or leaking, requiring replacement to restore safe mobility. The patient presents at a durable medical equipment (DME) supplier, wheelchair service clinic, outpatient rehabilitation clinic, or home (if a mobile technician is dispatched). The clinical workflow begins with patient report of a flat or slow leak during self-propulsion or clinic inspection during routine maintenance. A technician or clinician confirms the need for a replacement tube, documents wheelchair make/model, tire size, and whether the tube is for a front or rear wheel. The supplier verifies payer coverage and obtains necessary authorization if required. The tube (accessory) is dispensed and installed, or shipped with instructions; installation may be performed by a DME technician, occupational therapist, or the patient/caregiver. Documentation includes the item description E2212, serial/model of the wheelchair if available, size of the pneumatic tire, confirmation of fit, service date, and any performed adjustments. If replacement occurs during a therapy visit, the encounter notes link the accessory replacement to the functional mobility goal and safety assessment.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	When the tube is specifically for the left wheel and payer requires laterality reporting

HCPCS E2342: Power Wheelchair Nonstandard Seat Frame Depth, 20–21 Inches

HCPCS-E1226-WHEELCHAIR-RECLINING-BACK-ACCESSORY

HCPCS E1226: Wheelchair Manual Fully Reclining Back (>80°)

HCPCS-E2226-WHEELCHAIR-CASTER-FORK-REPLACEMENT

HCPCS Level II E2226: Manual Wheelchair Caster Fork, Replacement

HCPCS-E2502-SPEECH-GENERATING-DEVICE-DIGITIZED-8-20-MIN-RECORDING

HCPCS E2502: Speech Generating Device, Digitized Speech (8–20 min)

HCPCS-E1290-HEAVY-DUTY-WHEELCHAIR-DETACHABLE-ARMS-SWING-AWAY-FOOTREST

HCPCS Level II E1290: Heavy Duty Wheelchair with Detachable Arms and Swing-Away Footrest

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

HCPCS Level II E0218: Fluid Circulating Cold Pad with Pump

HCPCS-E2330-POWER-WHEELCHAIR-HEAD-CONTROL-PROXIMITY-SWITCH

HCPCS E2330: Power Wheelchair Head Control, Proximity Switch

HCPCS-E1092-WIDE-HEAVY-DUTY-WHEELCHAIR-DETACHABLE-ARMS-ELEVATING-LEG-RESTS

HCPCS E1092: Wide Heavy Duty Wheelchair with Detachable Arms and Elevating Leg Rests

HCPCS-E0250-HOSPITAL-BED-FIXED-HEIGHT-SIDE-RAILS-MATTRESS

HCPCS E0250: Hospital Bed, Fixed Height with Side Rails and Mattress

HCPCS-E0693-ULTRAVIOLET-LIGHT-THERAPY-6-FOOT-PANEL

HCPCS E0693: Ultraviolet Light Therapy System Panel, 6 Foot

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Taxonomy Code	Specialty	Notes
`174100000X`	Durable Medical Equipment & Medical Supplies	DME suppliers typically bill and furnish `E2212`
`173P00000X`	Assistive Technology Provider	Providers specializing in mobility aids install and fit wheelchair accessories
`213E00000X`	Occupational Therapist	OT performs mobility assessment and may arrange or install accessories during clinic visits
`207L00000X`	Physical Therapist	PT assesses propulsion mechanics and safety; documents clinical need for replacement
`331D00000X`	Wheelchair Seating and Mobility Specialist	Clinician focused on wheelchair configuration and accessory selection

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z99.3`	Dependence on wheelchair	Indicates long-term wheelchair use; replacement tube is an expected maintenance item
`M62.81`	Muscle weakness (generalized)	Patients with generalized weakness rely on wheelchairs and require functional, safe tires and tubes
`G82.50`	Paraplegia, unspecified, unspecified	Wheelchair-dependent patients with paralysis often need timely accessory replacement to maintain mobility
`G11.4`	Spinocerebellar ataxia	Neurologic disorders affecting coordination increase wear and puncture risk; replacement maintains safety
`R26.2`	Difficulty in walking, not elsewhere classified	Patients with ambulatory difficulty who use a wheelchair temporarily or intermittently may require tube replacement

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) with the patient, each 15 minutes	May be performed before or after tube replacement when treating mobility training or functional propulsion deficits in therapy sessions
`97760`	Orthotic(s) management and training, upper extremity, lower extremity, and/or trunk; initial encounter	May be used when overall mobility device management includes accessory fitting and training (documentation-dependent)
`99213`	Office or other outpatient visit for the evaluation and management of an established patient	Used when a clinician documents a problem-focused visit that includes assessment and arrangement of the replacement accessory
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Occasionally used for dispensing accessories in an office setting when payer allows clinician-supplied items (use per payer rules)
`99000`	Handling and/or conveyance of specimen for transfer from the patient to the laboratory	Data not relevant; Data not available in the input.

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