Summary & Overview

HCPCS Level II E2385: Power Wheelchair Caster Tire Tube, Replacement Only

HCPCS Level II code E2385 identifies a replacement tube for a pneumatic caster tire used on power wheelchairs. As a durable medical equipment accessory, this code covers single-item replacement parts necessary to maintain mobility devices. Nationally, accurate reporting of accessory codes like E2385 affects warranty documentation, supply chain management, and billing clarity for suppliers and payers handling durable medical equipment claims.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical and service context, typical sites of service, and which payers commonly adjudicate such accessory claims. The publication outlines benchmarks for billing practices, common modifier usage (listed separately), and policy or coverage considerations relevant to replacement parts for power wheelchairs.

This summary provides the practical context needed by billing staff, durable medical equipment suppliers, and revenue-cycle teams to code repairs and replacements correctly, understand payer expectations, and prepare for documentation requests. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2385HCPCS Level IIdurable medical equipmentpower wheelchair accessorycaster tire tubereplacement partmedical billingDME billingmobility device maintenance

Billing Code Overview

HCPCS Level II code E2385 describes a power wheelchair accessory: a tube for a pneumatic caster tire, any size, provided for replacement only, billed per item. Service type: Durable Medical Equipment (wheelchair accessory replacement). Typical site of service: Outpatient durable medical equipment suppliers, home delivery, or mobility device service centers.

Clinical & Coding Specifications

Clinical Context

A typical patient is a long-term power wheelchair user who presents to durable medical equipment (DME) service for a replacement pneumatic caster tire tube after a flat or routine maintenance reveals an irreparable tube. The patient is commonly seen in an outpatient DME clinic, home-visit repair service, or at a skilled nursing facility by a certified wheelchair technician or DME provider. The clinical workflow includes verification of the wheelchair make/model and caster size, inspection confirming the tube is a replacement-only component (no frame or motor repairs), documentation of medical necessity (patient mobility dependence, impact on safe ambulation/transport), obtaining payer authorization if required, procurement of the correct E2385 tube, and replacement by a trained technician. Typical payors involved in authorization and payment discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	When only part of an originally planned repair/service is provided (e.g., partial repair where full assembly replacement not performed).
`53`	Discontinued procedure	If service is started but discontinued due to unforeseen circumstances (rare for replacement-only tube).
`59`	Data not available in the input.	Data not available in the input.
`62`	Two surgeons	Data not available in the input.
`78`	Return to OR following surgery - unrelated to this procedure	Data not available in the input.
`80`	Assistant surgeon	Data not available in the input.
`LT`	Data not available in the input.	Data not available in the input.
`RR`	Rental equipment	Use when equipment is billed as rental rather than purchase; may apply in DME contexts with rental arrangements.
`RP`	Data not available in the input.	Data not available in the input.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When an APP provides parts of the clinical assessment related to DME service under appropriate supervision.

Taxonomy Code	Specialty	Notes
`261QP2400X`	Physical Medicine & Rehabilitation	Physicians and clinicians who assess mobility needs and order DME.
`173200000X`	Durable Medical Equipment & Medical Supplies Supplier	DME suppliers and technicians who provide and install `E2385`.
`207RR0500X`	Physical Therapist	PTs who evaluate mobility, recommend caster repair/replacement, and document functional impact.
`333600000X`	Home Health Agency	Agencies that coordinate in-home repairs and replacements for homebound patients.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z99.3`	Dependence on wheelchair	Primary reason for wheelchair maintenance and replacement parts like `E2385` to maintain mobility and safety.
`M62.81`	Muscle weakness (generalized)	Patients with generalized weakness rely on power wheelchairs; maintaining casters affects mobility function.
`G82.50`	Quadriplegia, unspecified	Individuals with high-level spinal cord injury commonly use power wheelchairs and require caster tube replacements.
`G82.20`	Paraplegia, unspecified	Lower extremity paralysis patients depend on wheelchair integrity; pneumatic caster tubes are routine consumable parts.
`R26.89`	Other abnormalities of gait and mobility	Mobility impairment diagnoses commonly accompany the need for durable medical equipment maintenance.
`Z46.6`	Encounter for fitting and adjustment of wheelchair	Administrative code used when fitting, adjusting, or repairing wheelchair components including caster tube replacement.

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	Performed by occupational or physical therapists to assess functional impact of a mobility device issue pre- or post-repair.
`97161`	Physical therapy evaluation - low complexity	Initial PT evaluation that may document need for DME repairs or replacement parts such as a caster tube.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedure, (list drugs, trays, supplies)	May be used by some payors for billing additional non-covered supplies associated with repair services when applicable.
`A9287`	Batteries, non-covered item code commonly used for DME supplies	Data not available in the input.
`T1999`	DME miscellaneous supplies and accessories	Used by some payors for miscellaneous DME accessory charges when a specific HCPCS is not accepted; `E2385` is the specific HCPCS for a caster tube, so `T1999` is rarely needed.