CurrentUnitedHealthcarePolicy CS357.D

Walkers (durable medical equipment)

UnitedHealthcare Community Plan medical policy governing coverage and coding for walkers and related accessories as durable medical equipment; references InterQual Medicare: Post Acute & Durable Medical Equipment, Walkers for clinical medical necessity criteria. Excludes specified states where separate state-specific policies apply.

Policy Summary

PayerUnitedHealthcare

PolicyWalkers (durable medical equipment)

Policy CodePolicy CS357.D

Change TypeMaterial coding update + template edits

Effective DateJul 1, 2025

Next Review Date

Key ActionProviders must document that walker coverage meets InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers clinical criteria; the policy defers to InterQual for specific inclusion/exclusion and clinical justification.

POLICY UPDATE CHANGES

07/01/2025 Template Update - Removed content/language pertaining to the state of Mississippi; Added HCPCS codes E0152 and E1399 to Applicable Codes; Archived previous policy version CS367.C

04/01/2026 Template Update - Removed content/language pertaining to the state of Louisiana.

18HCPCS/A-codes listed

10States with separate policies

Coverage Summary

Policy Number: CS357.D. Subject: Walkers (durable medical equipment). This UnitedHealthcare Community Plan medical policy governs coverage and coding for walkers and related accessories as durable medical equipment and references the third-party clinical criteria tool InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers to assist in medical necessity determinations. The policy is informational and intended to guide interpretation of standard benefit plans; federal, state, or contractual requirements may supersede the policy. Effective date: July 1, 2025. Last review: April 1, 2026.

Medical-Necessity Criteria

Coverage / Medical Necessity

Coverage is determined per InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers. Walkers are medically necessary in certain circumstances; refer to InterQual for specific clinical criteria.

InterQual clinical criteria: Medical necessity must meet InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers criteria
Click referenced InterQual criteria for detailed clinical inclusion/exclusion; policy defers to InterQual for clinical coverage rules
State-specific exclusions: Policy does not apply in listed states; see state-specific policy/guideline for Idaho, Kansas, Kentucky, Nebraska, New Jersey, New Mexico, North Carolina, Ohio, Pennsylvania, Tennessee, Indiana (Indiana indicates None)
If member resides in one of these states, use state-specific walker policy/guideline

Applicable Codes

Walkers - HCPCS codesHCPCSCovered

E0130	Walker, rigid (pickup), adjustable or fixed height
E0135	Walker, folding (pickup), adjustable or fixed height
E0140	Walker, with trunk support, adjustable or fixed height, any type
E0141	Walker, rigid, wheeled, adjustable or fixed height
E0143	Walker, folding, wheeled, adjustable or fixed height
E0144	Walker, enclosed, four-sided framed, rigid or folding, wheeled with posterior seat
E0147	Walker, heavy duty, multiple braking system, variable wheel resistance
E0148	Walker, heavy-duty, without wheels, rigid or folding, any type, each
E0149	Walker, heavy-duty, wheeled, rigid or folding, any type
E0152	Walker, battery powered, wheeled, folding, adjustable or fixed height

1–10 of 17

1/2

Replacement parts - HCPCSHCPCSCovered

A4636	Replacement, handgrip, cane, crutch, or walker, each
A4637	Replacement, tip, cane, crutch, walker, each

Reference applicable HCPCS codes when billing: When submitting claims, use the listed HCPCS codes (E0130–E0159, E1399) or replacement part codes (A4636, A4637) as appropriate; listing of a code does not guarantee coverage or reimbursement.

Provider Actions & Billing

Documentation Required

Use InterQual criteria to document medical necessity

Providers must document that walker coverage meets InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers clinical criteria; the policy defers to InterQual for specific inclusion/exclusion and clinical justification.

Billing Rule

Reference applicable HCPCS codes when billing

When submitting claims, use the listed HCPCS codes (E0130-E0159, E1399) or replacement part codes (A4636, A4637) as appropriate; listing of a code does not guarantee coverage or reimbursement.

E0130
E0135
E0140
E0141
E0143
E0144
E0147
E0148
E0149
E0152
E0154
E0155
E0156
E0157
E0158
E0159
E1399
A4636
A4637

Documentation Required

Follow state-specific policy when applicable

If member is in an excluded state listed in the Application section, providers must follow the applicable state-specific walker policy/guideline instead of this policy.

Background

Scope: This policy addresses use of walkers as durable medical equipment and provides guidance on coverage and coding. UnitedHealthcare may use third-party clinical tools such as InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers to assist in clinical determinations and to define medical necessity criteria. This policy is informational and does not replace review of the applicable federal, state, or contractual requirements for benefit coverage; those requirements govern in the event of a conflict.

InterQual®: A third-party clinical criteria tool (InterQual® Medicare: Post Acute & Durable Medical Equipment, Walkers) referenced for medical necessity determinations.

Revision History

07/01/2025material_coding_update

Material coding update: Added HCPCS codes E0152 and E1399 to Applicable Codes; removed content/language pertaining to the state of Mississippi; archived previous policy version CS367.C.

04/01/2026administrative_template_updateLatest

Administrative/template update: Removed content/language pertaining to the state of Louisiana.