Summary & Overview
HCPCS E2294: Pediatric Contoured Wheelchair Seat
HCPCS Level II code E2294 denotes a contoured pediatric wheelchair seat with fixed attaching hardware. This code identifies a durable medical equipment component intended to improve seating, positioning, and functional mobility for pediatric wheelchair users. Nationally, explicit coding for pediatric seating components matters for claims accuracy, durable medical equipment management, and patient access to appropriate mobility supports.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how E2294 is defined, typical sites of service, and the clinical context for pediatric seating. The publication summarizes billing and coverage benchmarks, common modifiers encountered on claims, and policy considerations that affect reimbursement and documentation requirements.
The content outlines the clinical role of contoured pediatric seats, expected claims workflows for durable medical equipment suppliers and outpatient clinics, and where documentation commonly focuses (medical necessity, fitting, and delivery). Data not available in the input will be noted where applicable. This resource serves billing professionals, DME suppliers, and clinicians seeking a concise reference on HCPCS Level II code E2294.
Billing Code Overview
HCPCS Level II code E2294 describes a seat, contoured, for pediatric size wheelchair including fixed attaching hardware. This item is a mobility assistive device component designed to provide a contoured seating surface sized for a pediatric patient and includes the fixed hardware required to attach the seat to a wheelchair frame.
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Service type: Durable medical equipment (wheelchair component) provided to support seating and positioning for pediatric wheelchair users.
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Typical site of service: Durable medical equipment supplier, outpatient clinic, home (delivered and fitted by supplier or clinician).
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A pediatric patient with neuromuscular weakness, cerebral palsy, or postural asymmetry is evaluated for seating support to improve posture, head control, and pressure distribution. An occupational therapist or pediatric rehabilitation specialist documents functional deficits (e.g., poor trunk control, pelvic obliquity, scoliosis) and requests a contoured pediatric wheelchair seat to provide custom-contoured support and integrate with the child’s wheelchair frame. The durable medical equipment (DME) supplier and clinical team coordinate measurements, trial seating if available, and select E2294 for a contoured pediatric-size wheelchair seat including fixed attaching hardware. The supplier obtains prior authorization when required by the payor, delivers the seat to the outpatient clinic, home, or school setting, and provides fitting, caregiver education, and documentation of medical necessity, seating assessment, and follow-up plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no modifier applies. |
22 | Increased procedural services |