HCPCS E2619: Replacement Cover for Wheelchair Seat or Back Cushion - OpenPayer

Summary & Overview

HCPCS E2619: Replacement Cover for Wheelchair Seat or Back Cushion

HCPCS Level II code E2619 denotes a replacement cover for a wheelchair seat cushion or back cushion, billed per cover. Nationally, this code matters because wheelchair cushion components and accessories are frequently required for ongoing mobility maintenance and pressure management in patients who use wheelchairs. Coverage and reimbursement policies for accessory items like covers affect durable medical equipment (DME) vendors, suppliers, clinicians prescribing accessories, and beneficiaries who rely on routine replacements.

Key payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of what E2619 represents, typical sites of service, and the clinical context for replacement covers. The publication also summarizes common billing practices, payer coverage patterns, and benchmarking visuals where available. Policy and coding updates relevant to HCPCS accessory codes are highlighted, along with practical notes on documentation expectations and billing contexts.

This executive summary orients supply chain managers, billing professionals, and clinicians to the role of E2619 in DME billing, and signals where to look for payer-specific rules and documentation requirements.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE2619HCPCS Level IIwheelchair accessoriesdurable medical equipmentcushion coverDME billingmedical codingaccessory replacement

Billing Code Overview

HCPCS Level II code E2619 describes a replacement cover for wheelchair seat cushion or back cushion, each. This service represents the provision of a standalone replacement cover intended to protect or replace the covering of a seat or back cushion used with a wheelchair.

Service type: Durable medical equipment accessory — replacement cushion or back cover
Typical site of service: Durable medical equipment supply settings, outpatient clinics, home delivery or home use

Clinical & Coding Specifications

Clinical Context

A patient who uses a manual or power wheelchair presents to durable medical equipment (DME) services requesting replacement of a worn or damaged cushion cover. Typical patients include individuals with chronic mobility impairment due to spinal cord injury, multiple sclerosis, cerebral palsy, severe osteoarthritis, or stroke who rely on a wheelchair for mobility and seating support. The clinical workflow begins with a clinician (physiatrist, occupational therapist, or DME supplier clinician) documenting the need: inspection of the existing cushion cover showing tears, soiling that cannot be cleaned, or loss of protective/waterproof properties that increases risk of skin breakdown. The clinician documents the patient’s diagnosis (for example, G82.20 paraplegia or M41.9 scoliosis), pressure-relief needs, and that the replacement is for the cushion seat or back cover only. An order is written for a replacement cover (billing code E2619) and submitted to the patient’s payer with supporting documentation including the product description, photos if applicable, and clinical justification referencing risk of pressure injury, hygiene, or functional deterioration. The DME supplier ships or fits the replacement cover in the patient’s home or clinic; training may be provided by an occupational therapist or DME technician on proper fit and maintenance. Follow-up includes verification the cover fits the existing cushion and monitoring for skin integrity changes at subsequent clinic visits.

Coding Specifications

Modifier	Description	When to Use

HCPCS E2327: Power Wheelchair Head Control Interface, Mechanical Proportional

HCPCS-E1230-POWER-OPERATED-VEHICLE-NONHIGHWAY

HCPCS E1230: Power Operated Vehicle (Three or Four Wheel Nonhighway)

HCPCS-E0200-HEAT-LAMP-TABLE-MODEL-INFRARED-ELEMENT

HCPCS E0200: Heat Lamp Table Model with Bulb/Infrared Element

HCPCS-E0960-WHEELCHAIR-SHOULDER-HARNESS-CHEST-STRAP

HCPCS E0960: Wheelchair Shoulder Harness or Chest Strap

HCPCS-E1233-PEDIATRIC-TILT-IN-SPACE-WHEELCHAIR-RIGID

HCPCS Level II E1233: Pediatric Tilt-in-Space Rigid Wheelchair

HCPCS-E1070-FULLY-RECLINING-WHEELCHAIR-DETACHABLE-ARMS-SWING-AWAY-FOOTREST

HCPCS E1070: Fully-Reclining Wheelchair with Detachable Arms and Swing-Away Footrest

HCPCS-E2402-NEGATIVE-PRESSURE-WOUND-THERAPY-PUMP

HCPCS E2402: Negative Pressure Wound Therapy Electrical Pump

HCPCS-E0691-ULTRAVIOLET-LIGHT-THERAPY-SYSTEM-LOCALIZED

HCPCS E0691: Ultraviolet Light Therapy System, Small Treatment Area

HCPCS-E0293-HOSPITAL-BED-VARIABLE-HEIGHT-HI-LO-NO-RAILS-NO-MATTRESS

HCPCS E0293: Hospital Bed, Variable Height Hi-Lo, No Rails, No Mattress

HCPCS-E0720-TENS-DEVICE-TWO-LEAD-LOCALIZED-STIMULATION

HCPCS E0720: Transcutaneous Electrical Nerve Stimulation, Two-Lead Localized

Showing 1–10 of 670

Taxonomy Code	Specialty	Notes
`251B00000X`	Physical Medicine & Rehabilitation Physician	Commonly documents medical necessity and writes orders for seating and cushioning.
`3336C0002X`	Occupational Therapist	Performs seating evaluations, fitting, and training for cushion covers and seating systems.
`261QP2300X`	Durable Medical Equipment & Supplies	DME supplier clinicians fit and supply replacement covers and bill `E2619`.
`103T00000X`	Physical Therapist	May perform functional seating assessments and recommend cushion components.
`207RG0300X`	Prosthetics & Orthotics	In complex seating systems, prosthetists/orthotists may be involved in component replacement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G82.20`	Paraplegia, unspecified	Patients with paraplegia commonly require specialized seating and replacement covers to prevent pressure injuries.
`G82.50`	Quadriplegia, unspecified	High-risk for skin breakdown and frequent need for durable, protective cushion covers.
`M54.5`	Low back pain	Chronic wheelchair users with back pain may require specialized back cushion covers for comfort and protection.
`I69.398`	Other sequelae of cerebrovascular disease	Stroke survivors with residual mobility impairment often need cushion covers for seating hygiene and skin protection.
`G35`	Multiple sclerosis	Progressive weakness and sensory loss increase risk of pressure injury; replacement covers maintain cushioning function.
`M41.9`	Scoliosis, unspecified	Spinal deformity often necessitates customized seating components and occasional cover replacement.
`L89.309`	Pressure ulcer of unspecified heel, stage 3	Presence or history of pressure ulcer increases clinical justification for intact, clean, protective cushion covers.
`R63.3`	Feeding difficulties and mismanagement (as proxy for poor nutrition)	Poor nutrition increases risk of skin breakdown, supporting need for protective cushion components.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99501`	Home visit for DME fitting and training	Used when a clinician or DME technician performs an in-home fitting or patient education for the replacement cover.
`97750`	Physical performance test or measurement; one or more performance tests	Used when therapists perform seating pressure mapping or functional testing related to cushion performance.
`97755`	Assistive technology assessment; includes evaluation of patient needs and recommendations	Used when an occupational or physical therapist conducts a seating system evaluation that results in ordering the replacement cover.
`99070`	Supplies and materials (durable medical equipment) used in the office	Used when billing incidental supplies or non-standard materials associated with fitting the cover.
`99456`	Work-related or medical disability evaluation services (may apply in vocational assessments)	Used when seating/cushion needs relate to disability determinations requiring documentation.

OpenPayer