Summary & Overview
HCPCS E2627: Wheelchair Shoulder/Elbow Mobile Arm Support
HCPCS Level II code E2627 represents a wheelchair-mounted, balanced, adjustable Rancho-type mobile arm support for shoulder and elbow assistance. This durable medical equipment accessory supports upper-extremity positioning and functional use for wheelchair users with limited proximal arm strength or control. Nationally, E2627 matters because it affects coverage decisions for mobility aids that directly impact independence, activities of daily living, and participation in community life.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, typical reimbursement considerations, and the clinical context in which a Rancho-type mobile arm support is prescribed and fitted. It highlights common service settings — home use with supplier or outpatient clinic fitting — and explains how the accessory integrates with wheelchair systems.
Readers will learn: payer coverage scope and common reimbursement themes for E2627; clinical indications and expected functional benefits of the device; typical sites of service and provider types involved in delivery and fitting; and gaps where specific payer policy details or diagnosis mappings are not provided. Data not available in the input will be clearly identified where relevant.
Billing Code Overview
HCPCS Level II code E2627 describes a wheelchair accessory: shoulder/elbow mobile arm support designed to attach to a wheelchair. The full description is "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type."
Service Type: Durable medical equipment accessory — wheelchair-mounted upper‑extremity support.
Typical Site of Service: Home or community settings where a wheelchair is used; installation and fitting commonly occur in durable medical equipment suppliers' facilities or outpatient rehabilitation clinics.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with post-stroke hemiparesis and significant shoulder subluxation presents for durable medical equipment evaluation. The patient uses a manual wheelchair and demonstrates impaired shoulder flexion and elbow control on the affected side, resulting in difficulty with feeding, grooming, and upper-extremity hygiene. A physical or occupational therapist performs a mobility and seating assessment and documents functional deficits, goals for improved independence in activities of daily living, and measurable benefit expected from a mobile arm support. A supplier of durable medical equipment fits a balanced, adjustable Rancho-type mobile arm support that attaches to the wheelchair frame to support the shoulder and elbow, allowing the patient to reach the mouth and tabletop with reduced effort and improved alignment. Clinical workflow includes ordered DME by the treating physician, therapist evaluation and measurable goals, trial fitting, documentation of medical necessity, delivery and training, and follow-up to assess functional benefit and need for adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component for services related to fitting or orthotic/ prosthetic adjustments billed separately by a clinician. |
52 |