HCPCS E2218: Manual Wheelchair Foam Propulsion Tire, Each - OpenPayer

Summary & Overview

HCPCS E2218: Manual Wheelchair Foam Propulsion Tire, Each

HCPCS Level II code E2218 designates a foam propulsion tire for manual wheelchairs, billed per item. As a durable medical equipment accessory, this code captures a small but important category of wheelchair replacement parts that affect mobility, comfort, and maintenance for wheelchair users nationwide. Reimbursement and coverage decisions for E2218 influence access to appropriate propulsion surfaces and can affect equipment longevity and user satisfaction.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how E2218 is used in billing for wheelchair accessories, typical sites of service where the item is provided, and which national payers commonly process claims for this code. The publication outlines practical benchmarks for expected claim handling, common modifier usage patterns where applicable, and clinical context explaining why a foam propulsion tire might be selected over other materials. It also notes where input data was not provided.

This summary serves clinicians, DME suppliers, and billing professionals seeking a national perspective on coding considerations for wheelchair propulsion tires and what to expect in payer interactions and policy considerations related to wheelchair accessories.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2218HCPCS Level IIwheelchair accessorydurable medical equipmentmobility aidsmedical billingprosthetics-orthoticsequipment replacement

Billing Code Overview

HCPCS Level II code E2218 describes a manual wheelchair accessory consisting of a foam propulsion tire, any size, billed each. This item is an accessory designed to replace or upgrade the propulsion surface on wheelchair drive wheels to provide improved grip, shock absorption, or reduced maintenance compared with standard tires.

Service type: Durable medical equipment accessory

Typical site of service: Outpatient settings, durable medical equipment suppliers, and patient home use

Clinical & Coding Specifications

Clinical Context

A patient who uses a manual wheelchair requires replacement propulsion tires due to wear, damage, or to improve rolling performance. Typical patients include individuals with long-term mobility impairment from spinal cord injury, multiple sclerosis, cerebral palsy, or age-related mobility limitations. The typical workflow: a wheelchair user presents to a durable medical equipment (DME) supplier, clinic, or outpatient rehabilitation department requesting a replacement foam propulsion tire. The supplier verifies wheelchair make/model and tire size, documents medical necessity and warranty status, confirms payer coverage, obtains any required prior authorization, dispenses the E2218 item, and documents delivery in the patient’s durable medical equipment record. The service most often occurs in an outpatient DME shop, orthotics/prosthetics clinic, home health delivery, or rehabilitation clinic. Ancillary clinical interactions may include a clinician or mobility specialist performing a quick mobility assessment to ensure proper fit and safe use after installation.

Coding Specifications

Modifier	Description	When to Use
`63`	Data not available in the input	Data not available in the input
`22`

HCPCS E0256: Hospital Bed, Variable Height Hi-Lo with Side Rails

HCPCS-E0830-AMBULATORY-TRACTION-DEVICE

HCPCS E0830: Ambulatory Traction Device, Each

HCPCS-E0890-TRACTION-FRAME-PELVIC-TRACTION

HCPCS Level II E0890: Traction Frame Attached to Footboard, Pelvic Traction

HCPCS-E0670-SEGMENTAL-PNEUMATIC-APPLIANCE-2-LEGS-AND-TRUNK

HCPCS Level II E0670: Segmental Pneumatic Appliance, 2 Legs and Trunk

HCPCS-E1234-PEDIATRIC-TILT-IN-SPACE-FOLDING-WHEELCHAIR

HCPCS Level II E1234: Pediatric Tilt-in-Space Folding Wheelchair

HCPCS-E2215-WHEELCHAIR-CASTER-TUBE

HCPCS E2215: Manual Wheelchair Caster Tube, Pneumatic

HCPCS-E2626-WHEELCHAIR-MOBILE-ARM-SUPPORT-SHOULDER-ELBOW

HCPCS Level II E2626: Wheelchair Mobile Arm Support, Shoulder-Elbow

HCPCS-E1223-WHEELCHAIR-DETACHABLE-ARMS-FOOTRESTS

HCPCS Level II E1223: Wheelchair with Detachable Arms and Footrests

HCPCS-E0782-IMPLANTABLE-NON-PROGRAMMABLE-INFUSION-PUMP

HCPCS E0782: Implantable Non-Programmable Infusion Pump

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

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

Showing 1–10 of 670

Taxonomy Code	Specialty	Notes
`332B00000X`	Durable Medical Equipment Supplier	Primary provider type that dispenses `E2218` and documents delivery.
`251B00000X`	Physical Medicine and Rehabilitation	Clinicians who assess mobility needs and prescribe wheelchair accessories.
`2080P0208X`	Prosthetist/Orthotist	Specialists who may fit and customize propulsion tires and advise on performance.
`367A00000X`	Occupational Therapist	Performs functional mobility evaluations and documents necessity for propulsion upgrades.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z99.3`	Dependence on wheelchair	Direct indication for wheelchair accessories such as propulsion tires.
`G82.20`	Paraplegia, unspecified	Patients with paraplegia commonly use manual wheelchairs and require tire replacement.
`G82.50`	Quadriplegia, unspecified	High-need manual wheelchair users who may require specialized propulsion components.
`G35`	Multiple sclerosis	Progressive mobility impairment often managed with manual wheelchair equipment.
`M62.81`	Muscle weakness (generalized)	Muscle weakness can necessitate manual wheelchair use and periodic accessory replacement.
`R26.2`	Difficulty in walking, not elsewhere classified	Mobility limitations that lead to manual wheelchair use and accessory needs.
`S14.109A`	Unspecified injury of cervical spinal cord, initial encounter	Traumatic spinal cord injuries resulting in long-term wheelchair dependence.
`M54.5`	Low back pain	Chronic conditions that may limit ambulation and increase reliance on manual wheelchairs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact, each 15 minutes	Mobility training that may accompany a new or replacement propulsion tire to ensure safe and effective use.
`97110`	Therapeutic exercises to develop strength and endurance, each 15 minutes	Used when physical therapy addresses mobility or strength changes related to wheelchair use.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Clinician visit to evaluate wheelchair fit, document medical necessity, and order the accessory.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	May be used for billable supplies if payer policy permits when provided in a clinical setting.
`97535`	Self-care/home management training, per 15 minutes	Occupational therapy training for propulsion technique after tire replacement.

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