Summary & Overview
HCPCS Level II E2626: Wheelchair Mobile Arm Support, Shoulder-Elbow
HCPCS Level II code E2626 represents a wheelchair accessory: a balanced, adjustable mobile arm support that attaches to a wheelchair to assist shoulder and elbow function. This code is nationally relevant because it identifies durable medical equipment used to improve upper-limb mobility and independence for wheelchair users, informing coverage, billing, and equipment provision decisions.
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 purpose and typical settings for the device, plus guidance on what to expect in payer coverage and billing practice at a national level. The publication summarizes common modifier use and payer variation where available, highlights relevant documentation considerations, and situates E2626 within durable medical equipment and mobility-assist services.
This report is intended for billing professionals, durable medical equipment suppliers, and clinicians involved in mobility device assessment. It focuses on the code definition, clinical context, and payer landscape rather than state-specific rules. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E2626 describes a wheelchair accessory: a shoulder-elbow, mobile arm support that is attached to the wheelchair and is balanced and adjustable. This device supports upper-limb function by stabilizing and assisting movement of the shoulder and elbow for wheelchair users.
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Service type: Durable medical equipment accessory for mobility support
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Typical site of service: Usage is typically in home, community, and other outpatient mobility settings where wheelchair users require arm support while seated in their wheelchair.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with post-stroke hemiparesis and chronic shoulder subluxation uses a manual wheelchair for community mobility. The patient demonstrates elbow and proximal arm weakness with impaired ability to maintain forearm position for activities of daily living. An occupational therapist evaluates for a balanced, adjustable mobile arm support that attaches to the wheelchair to stabilize the shoulder and elbow and enable reaching, feeding, and grooming. A durable medical equipment (DME) supplier fabricates and fits the E2626 accessory to the patient’s wheelchair during an outpatient DME visit. Documentation includes history of functional limitation, goals for improved independence, objective measurements of range of motion and strength, device trial results, and a plan of care signed by the prescribing physician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when a partial or reduced version of the mobile arm support is provided compared with full functionality. |
53 | Discontinued procedure |