Summary & Overview
HCPCS E2222: Manual Wheelchair Solid Caster Tire, Replacement
HCPCS Level II code E2222 denotes a replacement solid (rubber/plastic) caster tire with an integrated wheel for manual wheelchairs, billed per unit. This code captures routine wheelchair maintenance and part replacement that supports mobility and device safety for beneficiaries who use manual wheelchairs. Nationally, proper coding for replacement parts like E2222 matters for device longevity, patient safety, and consistent reimbursement across durable medical equipment (DME) suppliers and clinical settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, common claims and billing considerations, payer coverage patterns where available, and benchmarking guidance for coding and billing workflows. The publication highlights where E2222 is commonly used, how it aligns with DME service lines, and operational implications for suppliers and clinicians handling wheelchair repairs and part replacements. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E2222 describes a manual wheelchair accessory: a solid (rubber/plastic) caster tire with integrated wheel, provided as a replacement item, billed per each unit.
-
Service type: Durable medical equipment accessory; replacement caster wheel for manual wheelchairs
-
Typical site of service: Durable medical equipment suppliers, outpatient clinics, wheelchair repair or maintenance services, and any setting where manual wheelchair parts are replaced
Clinical & Coding Specifications
Clinical Context
A home-dwelling adult who uses a manual wheelchair for mobility presents when the front caster tire becomes worn, cracked, or separated, impairing rolling performance and steering control. The wheelchair user typically reports increased rolling resistance, vibration, and difficulty navigating carpeted surfaces or curbs. A durable medical equipment (DME) supplier or wheelchair technician performs an in-person evaluation in an outpatient clinic, DME store, skilled nursing facility, or the patient’s home to confirm the caster assembly requires replacement rather than repair. The technician documents wheelchair make/model, caster size, part number, and confirms the replacement part is a solid (rubber/plastic) caster tire with integrated wheel. The supplier dispenses and installs the replacement caster assembly, documents serial numbers and date of service, and provides patient education on inspection and maintenance. Billing is submitted using HCPCS Level II code E2222 for replacement of a single caster tire/wheel assembly, with the appropriate modifier if required by payer rules and the supplier’s charges reflect replacement only (no major rebuild or new wheelchair). Typical payor interactions involve prior authorization review for non-routine replacements for certain commercial plans or Medicare jurisdictions that request supporting documentation of medical necessity (safety, function, or wheelchair stability).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 |