Summary & Overview
HCPCS E2628: Wheelchair Shoulder/Elbow Mobile Arm Support, Balanced Reclining
HCPCS Level II code E2628 designates a balanced, reclining mobile arm support that attaches to a wheelchair to assist shoulder and elbow positioning. This device supports upper-limb alignment and function for wheelchair users with neuromuscular weakness, postural instability, or limited voluntary arm control. Nationally, the code matters because it identifies a distinct durable medical equipment (DME) item subject to coverage policies, documentation requirements, and supplier billing practices.
Key payers evaluated include Aetna, Blue Cross Blue Shield (BCBS), Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of what E2628 represents clinically and operationally, typical sites of service where the accessory is used, and common billing contexts. The publication outlines coverage considerations, documentation expectations, and comparator HCPCS items used for coding and supply classification. It also summarizes typical modifier usage and payer policy patterns where available.
This analysis is intended for clinicians, DME suppliers, and billing professionals seeking clarity on code definition, clinical role, and payer relevance at a national level. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code E2628 describes a wheelchair accessory: a shoulder/elbow mobile arm support that is balanced, reclining, and designed to be attached to a wheelchair. The device provides arm support and positioning for users who require assistance maintaining arm alignment and function while seated in a wheelchair.
Service type: Durable medical equipment / wheelchair accessory
Typical site of service: Outpatient settings, durable medical equipment suppliers, long-term care facilities, and patient residences where wheelchair mobility is used.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with chronic hemiparesis following a right-sided cerebrovascular accident presents for equipment assessment due to persistent shoulder subluxation and limited active elbow flexion that impairs feeding and hygiene. The durable medical equipment (DME) provider or physical medicine and rehabilitation clinician evaluates the patient in an outpatient clinic or a home visit and determines that a wheelchair-mounted, balanced, reclining mobile arm support is clinically necessary to support the affected upper extremity, reduce pain from shoulder impingement, and permit independent participation in activities of daily living.
The clinical workflow includes a therapist or physiatrist performing a functional assessment (range of motion, tone, pain, sitting balance), documenting inability to maintain shoulder/elbow position with standard armrests, obtaining measurements for device fitting, ordering the wheelchair accessory coded as E2628, coordinating with the wheelchair supplier for fabrication and mounting, and providing training to the patient and caregiver on safe use. Typical sites of service are outpatient rehabilitation clinics, durable medical equipment supplier facilities, and patient homes where the wheelchair is used and fitted.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery (per payer definitions) |