Summary & Overview

HCPCS E2219: Foam Caster Tire for Manual Wheelchair, Each

HCPCS Level II code E2219 denotes a foam caster tire for manual wheelchairs, billed per item. This code is relevant across durable medical equipment supply chains and rehabilitation services because caster tires affect wheelchair performance, safety, and user comfort. Nationally, consistent coding for accessories like foam caster tires supports accurate claims processing, inventory tracking, and maintenance reimbursement for suppliers and clinicians.

Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose and service context, common payer coverage considerations, and practical benchmarks for billing and claim adjudication where available. The publication also outlines the typical sites of service and the role of this accessory in wheelchair maintenance and patient mobility.

This summary serves clinicians, durable medical equipment suppliers, and billing professionals seeking clear guidance on code meaning and billing context. Data not available in the input is noted where applicable, and readers will be guided to sections covering modifiers, related codes, and payer-specific coverage policies when those details are provided elsewhere.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2219HCPCS Level IIwheelchair accessorydurable medical equipmentmobility aidsbillingclaims

Billing Code Overview

HCPCS Level II code E2219 represents a manual wheelchair accessory: a foam caster tire, any size, billed each. This accessory is intended for use on manual wheelchairs to provide cushioning and traction for the caster wheels.

Service type: Durable medical equipment accessory
Typical site of service: Durable medical equipment suppliers, outpatient clinics, home use

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult wheelchair user who presents to a durable medical equipment (DME) supplier or outpatient rehabilitation clinic requesting replacement caster tires for a manual wheelchair. The patient reports increased vibration, reduced rolling efficiency, or visible wear/flat spots on the small front caster wheels after months to years of use. A clinician (DME technician, occupational therapist, or physical therapist) inspects the wheelchair, documents the need for replacement parts, confirms the wheelchair model and caster size, and orders parts using billing code E2219 for each foam caster tire replaced. The workflow includes verification of patient identification, confirmation of medical necessity (documenting functional limitation or safety concern), measurement of caster tire size, supplier inventory check, installation or instruction for installation, and documentation of the item delivered, quantity, and any adjustments. Common settings for this service are outpatient DME suppliers, inpatient discharge planning for home use, home visits by DME technicians, and outpatient rehab clinics coordinating equipment maintenance prior to community discharge.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier / standard service	Use when no special circumstance or modifier applies to the supply of the foam caster tire.
`52`	Reduced services	Use if only a partial repair or limited portion of the ordered supply was provided.
`53`	Discontinued procedure	Use if the supply order was started but not completed and the item was not furnished.
`54`	Surgical care only	Not typically applicable; included for completeness if a surgical episode separately bills associated services.
`55`	Post-operative management only	Not typically applicable; may accompany related post-op durable equipment claims.
`62`	Two surgeons	Rarely applicable; use only if two providers with appropriate roles are involved in a documented episode where modifier is required.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure	Uncommon for DME; included when a return procedure necessitates additional durable goods on same claim line.
`80`	Assistant surgeon	Rarely relevant for supply items; use only if an assistant surgeon is payable and the supply is tied to the surgical episode.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when a qualified non-physician practitioner supplies or documents the medical necessity for the DME item per payer rules.
`KH`	Item furnished in connection with the treatment of a work-related injury by a physician of the employer	Use when payer requires this modifier for workers' compensation/work-related claims for the supply.
`NU`	New equipment	Use when the foam caster tire is billed as a new, first-time component for the wheelchair.
`RR`	Rental billed item	Use only if the item is billed under a rental arrangement rather than purchase; typically not applicable to single replacement parts but included if payer classifies differently.
`QY`	Services furnished by a certified registered nurse anesthetist (CRNA) billing under their own NPI	Not typical for DME; listed when payer-specific coding requires practitioner-specific modifiers.
`UE`	Single or family of codes to indicate unusual event or circumstance	Use when an exceptional billing circumstance requires the `UE` modifier per payer guidance.

Taxonomy Code	Specialty	Notes
`233K00000X`	Physical Therapist	PTs often assess mobility equipment needs, document functional limitations, and recommend repairs or replacements.
`3336C0003X`	Durable Medical Equipment Supplier	DME suppliers furnish and install wheelchair components and submit the `E2219` claim.
`251B00000X`	Occupational Therapist	OTs evaluate seating and mobility, determine need for maintenance parts, and document medical necessity.
`207Q00000X`	Orthotist/Prosthetist	May be involved when wheelchair modifications or component compatibility issues require specialist input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Weakness may increase reliance on manual wheelchair mobility and the need for reliable caster function; worn tires impair mobility.
`G82.50`	Paraplegia, unspecified	Patients with paraplegia commonly use manual wheelchairs; caster tire replacement maintains safety and mobility.
`G83.4`	Cauda equina syndrome	Patients with lower-limb paralysis or sensory loss require functional wheelchair components for mobility and skin protection.
`M54.5`	Low back pain	Chronic low back pain can lead to increased wheelchair use for mobility during flare-ups; maintenance of wheelchair components supports function.
`R26.2`	Difficulty in walking, not elsewhere classified	Patients with ambulatory difficulty who use manual wheelchairs depend on properly functioning casters for community mobility.
`Z45.2`	Fitting and adjustment of external prosthetic device	Captures encounters for adjustment or fitting of mobility devices and components such as caster tires.
`Z99.3`	Dependence on wheelchair	Directly documents wheelchair dependence and supports medical necessity for replacement parts.
`S79.92XA`	Unspecified injury of lower leg, initial encounter	Acute injuries that increase wheelchair reliance may lead to equipment maintenance needs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	Used when a therapist provides training on wheelchair use, transfers, or propulsion technique in conjunction with equipment maintenance.
`97035`	Ultrasound therapeutic (if used)	Rarely related; included when soft-tissue assessment is performed as part of a broader therapy visit that also addresses mobility equipment needs.
`97760`	Orthotic(s)/protective device(s) training (includes assessment and fitting)	Used when clinicians provide instruction or fitting related to wheelchair components and patient training on new parts.
`97542`	Wheelchair management (e.g., assessment, fitting, training)	Directly related when formal wheelchair assessment and management are provided alongside ordering or fitting replacement caster tires.
`99455`	Work-related or medical disability evaluation services (by employer request)	May be used when an evaluation for return-to-work includes equipment repair or replacement recommendations.